重症急性胰腺炎——我们能有多保守？
Severe Acute Pancreatitis - How Conservative Can We Be?
作者信息
Alberts Christian, Alsfasser Guido
机构信息
Department of General, Thoracic, Vascular and Transplantation Surgery, University of Rostock, Rostock, Germany.
出版信息
Visc Med. 2018 Dec;34(6):432-434. doi: 10.1159/000494097. Epub 2018 Nov 17.
BACKGROUND
Acute pancreatitis still is a disease with overall high mortality. Continuously improved understanding of the pathophysiology, however, led to changes in treatment algorithms within the last decades, thus resulting in decreased mortality. This knowledge of acute pancreatitis enabled a new classification system introduced by an international expert panel. This classification system is helpful in initiating treatment strategies which are adapted to the course of acute pancreatitis. Especially the role of surgery experienced a paradigm shift towards a more conservative approach.
METHODS
A specific literature search regarding the treatment of acute pancreatitis was performed in the PubMed database, and the results of key studies were compared. Results of these studies are discussed in the context of the most recent international classification system.
RESULTS AND CONCLUSION
Based upon the available data, we can summarize that conservative treatment of acute pancreatitis with pancreatic necrosis is a valid treatment option for selected cases and is associated with reduced mortality compared to more aggressive therapy. However, patients with acute pancreatitis should be treated in experienced centers.
背景
急性胰腺炎仍然是一种总体死亡率较高的疾病。然而，在过去几十年里，对其病理生理学的认识不断提高，导致了治疗方案的改变，从而使死亡率有所下降。对急性胰腺炎的这种认识促成了一个由国际专家小组推出的新分类系统。该分类系统有助于启动适应急性胰腺炎病程的治疗策略。特别是手术的作用经历了向更保守方法的范式转变。
方法
在PubMed数据库中进行了关于急性胰腺炎治疗的特定文献检索，并比较了关键研究的结果。这些研究的结果在最新国际分类系统的背景下进行了讨论。
结果与结论
根据现有数据，我们可以总结出，对于选定的病例，对伴有胰腺坏死的急性胰腺炎进行保守治疗是一种有效的治疗选择，并且与更积极的治疗相比，死亡率更低。然而，急性胰腺炎患者应在有经验的中心接受治疗。
Zotero 插件