| 引用本文： |
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杜越晨,倪建波,万荣.感染性胰腺坏死的治疗进展[J].同济大学学报（医学版）,2020,41(6):796-800. [点击复制]
- DU Yue-chen,NI Jian-bo,WAN Rong.Treatment progress of infected pancreatic necrosis[J].同济大学学报（医学版）,2020,41(6):796-800. [点击复制]
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| 摘要: |
| 急性胰腺炎是一种内科常见急症，胰腺坏死并发感染可导致严重脓毒血症甚至多器官功能衰竭。近年来，随着消化内外科微创手术水平的快速提高，微创升阶梯理念已逐渐代替外科清创，成为胰腺感染性坏死（infected pancreatic necrosis, IPN）的首选治疗策略。本文对超声内镜下穿刺引流-内镜下经腔坏死切除术-LAMS支架置入+鼻胆管引流的消化内镜下升阶梯治疗策略的有效性、安全性以及内镜下操作细节等作一详细综述，对内镜升阶梯治疗与外科微创升阶梯治疗策略的各自优势进行阐述，为IPN临床治疗策略的选择提供理论指导。 |
| 关键词: 感染性胰腺坏死 内镜下坏死清除术 升阶梯治疗 |
| DOI：10.16118/j.1008-0392.2020.06.019 |
| 投稿时间：2019-11-20 |
| 基金项目:国家自然科学基金（81400663、81802318）；上海市卫生和计划生育委员会项目（ZY(2018—2020)-FWTX-1004 ） |
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| Treatment progress of infected pancreatic necrosis |
| DU Yue-chen,NI Jian-bo,WAN Rong |
| (Dept. of Gastroenterology, Shanghai First People’s Hospital, Shanghai 200080, China) |
| Abstract: |
| Acute pancreatitis is a common gastrointestinal disorder. Infected pancreatic necrosis (IPN) can result in severe sepsis and eventually multiple organ failure (MODS). In recent years, the minimally invasive step-up approach has gradually replaced surgical debridement and become the preferred treatment choice for IPN. This review summarized the effectiveness, safety and procedure details of the minimally invasive step-up approach for IPN, including ultrasound-guided endoscopic transluminal drainage, endoscopic transluminal necrossectomy, lumen-apposing metal stents implantation and nasobiliary drainage based on the relevant literature; and also elaborates the advantages of minimally invasive and endoscopic step-up approach to provide information for clinical treatment of IPN. |
| Key words: infected pancreatic necrosis endoscopic transluminal necrosectomy step-up approach |
