急性胰腺炎相关腹腔积液的研究进展

Research advances in acute pancreatitis-associated ascites fluid

急性胰腺炎(AP)相关腹腔积液是AP患者常见的并发症,与患者疾病严重程度、局部及全身并发症的发生及预后密切相关。胰腺炎相关腹腔积液产生可能来源于腹腔内血管、淋巴管及胰管的渗漏等。近年来,研究发现通过腹腔穿刺引流早期积极清除胰腺炎相关腹腔积液有助于降低全身炎症水平及缓解胰腺炎相关器官损伤,从而改善重症AP患者病情及降低病死率。但胰腺炎相关腹腔积液如何加重全身炎症反应、参与胰腺和远处器官损害,以及如何导致AP患者病情恶化,尚不完全清楚。因而,本文就AP相关腹腔积液的概况及近年来的研究做一综述,为AP病理生理过程及治疗的探索提供一些方向。

Acute pancreatitis-associated ascites fluid(PAAF)is a common complication in patients with acute pancreatitis(AP)and is closely associated with the severity of AP,the development of local and systemic complications,and prognosis.PAAF may originate from the leakage of abdominal blood vessels,lymphatic vessels,and pancreatic duct.Recent studies have found that early removal of PAAF by abdominal paracentesis drainage can help to reduce systemic inflammation and alleviate pancreatitis-associated organ injury,thereby improving the conditions of patients with severe AP and reducing mortality.However,it is still not completely clear how PAAF aggravates systemic inflammatory response,participates in pancreatic injury and damage of distal organs,and leads to the aggravation of disease conditions in patients with AP.Therefore,this article gives an overview of PAAF and summarizes related studies in recent years,so as to provide directions for exploring the pathophysiological process and treatment of AP.