重症急性胰腺炎治疗的几个问题

Insights into the Treatment of Severe Acute Pancreatitis

急性胰腺炎是消化系统常见急症，分为轻症急性胰腺炎（MAP）和重症急性胰腺炎（SAP），其中80％的患者为MAP，病情具有自限性，预后良好，而SAP因常伴有诸多局部和系统性并发症，死亡率高。胰腺或胰腺周围坏死感染是SAP最严重的并发症，其病死率高达30％。虽然抗生素、肠内营养和益生菌都被用来预防胰腺感染，但只有肠内营养的作用被肯定，而其余两者在SAP中的作用还存在较多争议。

Acute pancreatitis is a common gastrointestinal emergency, which comprises mild acute pancreatitis （MAP） and severe acute pancreatitis （SAP）. About 80% of cases presents as a mild, self-limiting disease with low morbidity and mortality, however, patients who suffer from SAP will experience serious local and/or systemic complications associated with high mortality. Infection of pancreatic or peripancreatic tissue with necrosis is the most serious complication with a mortality rate as high as 30%. Antibiotics, enteral nutrition and probiotics have heen used to prevent the pancreatic infection; however, only enteral nutrition has been proved to be effective. There are still some controversy on the use of antibiotics and probiotics in SAP.