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胰腺炎急性胃肠损伤研究进展
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Abstract:
急性胰腺炎是一种临床中较为常见的疾病，主要由胰酶的异常活化导致对自身及邻近脏器的消化，从而引发胰腺部位的炎症反应。该疾病的发生通常由暴饮暴食、胆道结石、血脂异常、过量饮酒以及感染等多种因素引发。近年来，随着中国经济的蓬勃发展和全民生活素质的提高，人们的膳食选择发生了翻天覆地的变化。与此同时，急性胰腺炎的发病频率、重症病例的转化率以及患者的死亡比例也以每年攀升的趋势发展，这对广大患者的身体健康和生活品质带来了严峻的挑战。而急性胰腺炎患者病情严重时，释放的炎症递质及组织坏死物质会影响胃肠道功能，若治疗不及时，可能进一步引起肠道菌群失衡及肠源性内毒素血症，从而诱发感染性胰腺坏死，影响患者预后。急性胃肠道功能损伤可能会引发失控性炎症反应，导致胰腺以及其他器官的进一步损害，形成恶性循环，严重时可能发展为多器官功能障碍综合征，因此胃肠道是AP诊治过程中不可或缺的一环。现就国内外在此领域的研究，对急性胰腺炎胃肠损伤的研究进展做一个概述，期望能够提供一套更为高效的早期诊断和治疗胰腺炎急性胃肠损伤的参考方案。
Acute pancreatitis is a relatively common disease. It is mainly caused by irregular activation of pancreatic enzymes, leading to autolysis of the pancreas and surrounding organs, and initiating an inflammatory response within the pancreas. The disease is usually triggered by a variety of factors, including overeating, gallstone disease, dyslipidemia, excessive alcohol consumption, and infections. In recent years, as China’s economy has prospered and the general population’s standard of living has improved, there have been notable changes in people’s dietary habits. Currently, the frequency of acute pancreatitis, the conversion rate of severe cases, and the proportion of patients who die have been steadily escalating annually, posing significant challenges to the health and quality of life of a substantial portion of patients. When patients with acute pancreatitis are critically ill, released inflammatory transmitters and tissue necrosis substances can negatively affect the functioning of the gastrointestinal tract. If not treated quickly, it may further worsen the imbalance in intestinal flora and lead to enterogenous endotoxemia, potentially causing infectious pancreatic necrosis and further affecting patient outcomes. Gastrointestinal dysfunction can trigger an unregulated inflammatory response, leading to additional damage to the pancreas and other organs, establishing a vicious cycle that can potentially develop into multiple organ dysfunction syndrome in severe cases. Therefore, the gastrointestinal tract plays a pivotal role in the diagnosis and treatment of acute pancreatitis. This article summarizes the research progress of gastrointestinal injury in acute pancreatitis at home and abroad, aiming to provide a more effective reference for the early diagnosis and treatment of acute gastrointestinal injury in pancreatitis.
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