急性坏死性胰腺炎外科治疗现状及介入处理时机的研究进展

张聪; 李成

doi:10.16766/j.cnki.issn.1674-4152.004262

急性坏死性胰腺炎外科治疗现状及介入处理时机的研究进展

doi: 10.16766/j.cnki.issn.1674-4152.004262

张聪^,,
李成

四川大学华西医院普外科胰腺外科病房，四川成都 610041

基金项目:

四川省科技计划项目 2024YFHZ0053

详细信息

通讯作者:
张聪，E-mail: 18382357812@163.com

中图分类号: R657.51
计量
- 文章访问数: 7
- HTML全文浏览量: 8
- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2024-11-27
- 网络出版日期: 2026-01-07

Research progress of surgical treatment status and optimal timing of therapy in acute necrotizing pancreatitis

ZHANG Cong^,,
LI Cheng

Division of Pancreatic Surgery Unit, Department of General Surgery, West China Hospital Sichuan University, Chengdu, Sichuan 610041, China

摘要

摘要: 急性坏死性胰腺炎(acute necrotizing pancreatitis, ANP)是一种常见急性病，其引起的胰腺组织坏死可导致严重的并发症和高死亡率。早期外科手术治疗可以迅速介入，阻止病情的进一步恶化，从而显著提高患者的生存率。随着医疗技术的不断进步，微创技术在急性坏死性胰腺炎的外科治疗中逐渐占据主导地位，因其创伤小、恢复快的特点受到广泛关注。有研究指出，对于轻度ANP，早期非手术治疗仍是首选，但对于存在感染性坏死、腹腔间隔综合征、出血或生命体征不稳定等严重并发症的患者，及时的外科介入成为挽救生命的关键。本文在探讨ANP外科治疗现状的基础上，重点介绍保守治疗与外科手术治疗方法的种类及适应证，对介入治疗在ANP中的应用及效果进行详细探讨，包括超声引导下经皮穿刺引流(PCD)、放射介入治疗和内镜介入疗法的应用，特别强调介入处理时机对ANP患者预后的重要性，包括早期介入治疗的优势和合理时机选择的策略，探讨未来发展趋势与研究方向，旨在为制定更合理的治疗方案和优化介入处理时机提供科学依据。
- 急性坏死性胰腺炎 /
- 外科治疗 /
- 介入处理时机 /
- 内镜介入
Abstract: Acute necrotizing pancreatitis (ANP) is a common and severe acute disease. The necrosis of pancreatic tissue caused by ANP can lead to serious complications and high mortality. Early surgical treatment can help prevent further disease progression and significantly improve the survival rate of patients. With continuous advancements in medical technology, minimally invasive approaches have gradually occupied the mainstay of surgical treatment for ANP, and its characteristics of small trauma and rapid recovery have received extensive attention. Studies have pointed out that conservative management remains the first-line approach for patients with mild ANP. However, for patients with severe complications such as infectious necrosis, abdominal compartment syndrome, bleeding or unstable vital signs, timely surgical intervention is critical for improving outcomes. Based on a comprehensive review of the current situation of surgical treatment of ANP, this review focuses on the types and indications of both conservative and surgical treatments, and provides an in-depth discussion of various interventional therapy in ANP, including ultrasound-guided percutaneous catheter drainage (PCD), radiation interventional therapy, and endoscopic interventional therapy. This review emphasizes the importance of interventional treatment timing in the prognosis of ANP patients, elaborates on the advantages of early interventional therapy and appropriate timing strategies, and explores future trends and research directions to provide clinicians in evidence-based treatment plans and optimizing interventional treatments.
- Acute necrotizing pancreatitis /
- Surgical treatment /
- Interventional treatment timing /
- Endoscopic intervention

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