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Current status and thinking of diagnosis and treatment of severe acute pancreatitis
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摘要: 急性胰腺炎的诊治指南是临床医师救治急性胰腺炎尤其是重症急性胰腺炎(SAP)的重要依据,但是我国目前存在很多环节在认识和实施上不统一的现状,直接影响到SAP的救治效果和成功率。从SAP的诊断标准和治疗措施两方面,就其中临床关心的焦点问题作一阐述,希望能引起关于SAP临床诊治的思考和讨论。Abstract: The guidelines for the diagnosis and treatment of acute pancreatitis are the important reference for clinicians in treating acute pancreatitis, especially severe acute pancreatitis (SAP) .However, currently there is much discrepancy on the opinion and practice in China, which affects the treatment outcome and cure rate of this disease.Clinical focuses are described in terms of the diagnostic criteria and treatment for SAP, with the hope of initiating reflection and discussion on the clinical diagnosis and treatment of SAP.
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Key words:
- pancreatitis, acute necrotizing /
- early diagnosis /
- therapeutics /
- editorial
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[1]Pancreas Study Group, Chinese Society of Gastroenterology, Chinese Medical Association, Editorial Board of Chinese Journal of Pancreatology, Editorial Boaard of Chinese Journal of Digestion.Chinese guidelines for the management of acute pancreatitis (Shanghai, 2013) [J].J Clin Hepatol, 2013, 29 (9) :656-660. (in Chinese) 中华医学会消化病学分会胰腺疾病学组, 《中华胰腺病杂志》编辑委员会, 《中华消化杂志》编辑委员会.中国急性胰腺炎诊治指南 (2013年, 上海) [J].临床肝胆病杂志, 2013, 29 (9) :656-660. [2]BANKS PA, BOLLEN TL, DERVENIS C, et al.Classification of acute pancreatitis-2012:revision of the Atlanta classification and definitions by international consensus[J].Gut, 2013, 62 (1) :102-111. [3]Chinese College of Emergency Physicians.2013 Chinese guidelines for emergency treatment of acute pancreatitis[J].Chin J Crit Care Med, 2013, 33 (12) :1-16. (in Chinese) 中国医师协会急诊医师分会.2013中国急诊急性胰腺炎临床实践指南[J].中国急救医学, 2013, 33 (12) :1-16. [4]VEGE SS, GARDNER TB, CHARI ST, et al.Low mortality and high morbidity in severe acute pancreatitis without organ failure:a case for revising the Atlanta classification to include“moderately severe acute pancreatitis”[J].Am J Gastroenterol, 2009, 104 (3) :710-715. [5]CHANG YS, FU HQ, XIAO YM, et al.Nasogastric or nasojejunal feeding in predicted severe acute pancreatitis:a meta-analysis[J].Crit Care, 2013, 17 (3) :r118. [6]BAI Y, GAO J, ZOU DW, et al.Prophylactic antibiotics cannot reduce infected pancreatic necrosis and mortality in acute necrotizing pancreatitis:evidence from a meta-analysis of randomized controlled trials[J].Am J Gastroenterol, 2008, 103 (1) :104-110. [7]TENNER S, BAILLIE J, DEWITT J, et al.American College of Gastroenterology guideline:management of acute pancreatitis[J].Am J Gastroenterol, 2013, 108 (9) :1400-1415, 1416. -
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