Janisch Nigeen H, Gardner Timothy B
Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
Geisel School of Medicine at Dartmouth, Hanover, NH, USA; Section of Gastroenterology and Hepatology, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA.
Gastroenterol Clin North Am. 2016 Mar;45(1):1-8. doi: 10.1016/j.gtc.2015.10.004. Epub 2015 Dec 19.
This article reviews advances in the management of acute pancreatitis. Medical treatment has been primarily supportive for this diagnosis, and despite extensive research efforts, there are no pharmacologic therapies that improve prognosis. The current mainstay of management, notwithstanding the ongoing debate regarding the volume, fluid type, and rate of administration, is aggressive intravenous fluid resuscitation. Although antibiotics were used consistently for prophylaxis in severe acute pancreatitis to prevent infection, they are no longer used unless infection is documented. Enteral nutrition, especially in patients with severe acute pancreatitis, is considered a cornerstone in management of this disease.
本文综述了急性胰腺炎治疗方面的进展。对于这一诊断,药物治疗主要是支持性的,尽管进行了广泛的研究,但尚无改善预后的药物疗法。尽管关于补液量、液体类型和给药速度仍存在争议,但目前治疗的主要方法是积极的静脉液体复苏。虽然抗生素曾一直用于重症急性胰腺炎的预防以防止感染,但除非有感染记录,否则不再使用。肠内营养,尤其是在重症急性胰腺炎患者中,被认为是该病治疗的基石。