急性胰腺炎早期干预的时效性

The Significance of Early Intervention in Acute Pancreatitis

急性胰腺炎是累及胰腺及其周围组织的炎性病变,其中重症急性胰腺炎(severe acute pancreatitis,SAP)可引起器官衰竭,病死率较高。入院后最初24 h内的早期干预对改善SAP预后至关重要。有证据提示,早期预测SAP疾病严重程度、充分补液及早期肠内营养有助于改善临床转归。不加选择地预防性应用抗生素及早期经内镜逆行性胰胆管造影术对SAP患者无效。但现有多数研究样本量较小,证据级别较低,有待更多高质量的研究阐明SAP患者早期的治疗选择。

Acute pancreatitis is an inflammatory entity involving the pancreas and peri-pancreatic tissues.Severe acute pancreatitis leads to persistent organ failure and high mortality.Treatment in the first 24 hours of admission is crucial for the prognosis.Current evidence indicates that adequate fluid resuscitation with lactated Ringer’s and early enteral nutrition may be effective,but prophylactic antibiotics and early ERCP should not be routinely used.The small sample size is a major limitation for current research.Large scale,multi-center randomized controlled trials are eagerly awaited.