Walling Anne, Freelove Robert
Department of Family and Community Medicine, University of Kansas School of Medicine-Wichita, 1010 North Kansas, Wichita, KS 67214, USA.
Department of Family and Community Medicine, University of Kansas School of Medicine-Wichita, Smoky Hill Family Medicine Residency, 651 East Prescott Avenue, Salina, KS 67401, USA.
Prim Care. 2017 Dec;44(4):609-620. doi: 10.1016/j.pop.2017.07.004. Epub 2017 Oct 5.
Most cases of acute pancreatitis are related to gallstones. More than 80% resolve within a few days. The diagnosis is based on upper abdominal pain, elevated lipase and/or amylase, and transabdominal ultrasound findings. Management requires early aggressive hydration, pain control, nutritional support, and monitoring for progression. Patients who develop hypovolemia, systemic inflammatory response, pancreatic necrosis, and organ failure have high mortality, risk of recurrence, and progression to chronic pancreatitis (CP). Genetic predisposition and repeated injury may be necessary for CP. Management requires control of pain and exocrine and endocrine symptoms, plus reduction of risk factors, especially alcohol intake.
大多数急性胰腺炎病例与胆结石有关。超过80%的病例在数天内可自行缓解。诊断依据为上腹部疼痛、脂肪酶和/或淀粉酶升高以及经腹超声检查结果。治疗需要早期积极补液、控制疼痛、营养支持以及监测病情进展。出现低血容量、全身炎症反应、胰腺坏死和器官衰竭的患者死亡率高、复发风险高，且易发展为慢性胰腺炎（CP）。CP可能需要遗传易感性和反复损伤。治疗需要控制疼痛以及外分泌和内分泌症状，同时降低危险因素，尤其是酒精摄入。
