外科理论与实践 ›› 2022, Vol. 27 ›› Issue (06): 563-568.doi: 10.16139/j.1007-9610.2022.06.017

• 综述 • 上一篇    下一篇

急性胰腺炎抗感染治疗现状

文艺, 倪童天, 陈影 综述, 毛恩强 审校()   

  1. 上海交通大学医学院附属瑞金医院急诊科,上海 200025
  • 收稿日期:2021-12-13 出版日期:2022-11-25 发布日期:2023-01-30
  • 通讯作者: 毛恩强,E-mail: maoeq@yeah.net
  • 基金资助:
    上海市公共卫生体系建设三年行动计划(2020-2022);重点学科建设计划(GWV-10.1-XK22);上海市科学技术委员会“科研计划项目”(18411966400)

Current status on anti-infective treatment of acute pancreatitis

WEN Yi, NI Tongtian, CHEN Ying, MAO Enqiang()   

  1. Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2021-12-13 Online:2022-11-25 Published:2023-01-30

摘要:

急性胰腺炎(acute pancreatitis,AP)是急诊病人就诊的常见原因,也是较常见入院治疗的重症疾病之一。本文对AP的炎症反应特点、AP合并感染的类型与病原学、预防性使用抗菌药物的必要性、AP合并感染的抗菌药物治疗、胰腺外感染的抗菌药物使用以及外科干预的抗感染治疗进行综述,拟为AP的治疗提供相关临床认识和经验。AP病人出现胰腺外感染表明病情加重。与无菌性坏死病人相比,胰腺外感染病人发生器官衰竭、进入重症监护室抢救的风险高,死亡率也明显增高。早期诊断、控制感染和适当的抗菌药物治疗是AP合并感染治疗的基石。

关键词: 急性胰腺炎, 抗菌药物, 胰腺感染

Abstract:

Acute pancreatitis (AP) is a common cause of emergent patients and common severe disorders of hospital admission. This review includes the characteristic of inflammatory reaction from AP, the pattern and the aetiology of AP with infection, the necessity of preventive use of antibacterials, antimicrobial treatment of AP with infection, use of antibacterials for extra-pancreatic infections, surgical intervention of anti-infective treatment. Related recognition and clinical experience in treatment of AP were provided. Extra-pancreatic infections appeared in the patients with AP indicating the increase in disease severity. Compared to the patients with aseptic necrosis, the patients with extra-pancreatic infections might have organ failure, increasing in rescue risk for into intensive care unit, and with mortality increasing. Early diagnosis, infection control and proper treatment with antibacterials will be the footing and base for the treatment of AP combined infection.

Key words: Acute pancreatitis, Antibacterials, Pancreatic infection

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