CAJ | 학술논문

重度急性胰腺炎（SAP）是临床常见的急危重症，尤其是在继发胰腺坏死组织感染时，其病死率可高达40％。肠黏膜屏障功能障碍和肠源性细菌易位是引起胰腺坏死组织和胰周积液感染、促使全身性炎症反应综合征（SIRS）和多器官功能障碍综合征（MODS）发生的主要原因。由于肠道功能多样，难以归纳总结，且目前缺乏特异的、客观的评价指标，故肠功能障碍并未被纳入“2012版急性胰腺炎分类———亚特兰大国际共识分类和定义修订”的改良 Marshall 器官衰竭评估体系中。临床工作中重视 SAP 肠功能障碍的防治，是减少胰腺坏死组织感染，防止MODS 发生、发展，降低 SAP 病死率的关键。本文对 SAP 肠功能障碍的发生机制及其防治作一阐述。
중도급성이선염（SAP）시림상상견적급위중증，우기시재계발이선배사조직감염시，기병사솔가고체40％。장점막병장공능장애화장원성세균역위시인기이선배사조직화이주적액감염、촉사전신성염증반응종합정（SIRS）화다기관공능장애종합정（MODS）발생적주요원인。유우장도공능다양，난이귀납총결，차목전결핍특이적、객관적평개지표，고장공능장애병미피납입“2012판급성이선염분류———아특란대국제공식분류화정의수정”적개량 Marshall 기관쇠갈평고체계중。림상공작중중시 SAP 장공능장애적방치，시감소이선배사조직감염，방지MODS 발생、발전，강저 SAP 병사솔적관건。본문대 SAP 장공능장애적발생궤제급기방치작일천술。
Severe acute pancreatitis( SAP),especially with secondary infection of pancreatic necrotic tissue,is clinically a very severe and critical condition. The mortality rate can be as high as 40% . Intestinal barrier dysfunction and translocation of enteric bacteria contribute to the infection of pancreatic necrotic tissue and peripancreatic accumulated fluid,promote systemic inflammatory response syndrome( SIRS)and multiple organ dysfunction syndrome( MODS). Because there is no specific and objective assessment criteria for intestinal function and the function is diversity,intestinal dysfunction is not included in the modified Marshall organ dysfunction scoring system in 2012 revision of the Atlanta International Consensus on Classification and Definitions of Acute Pancreatitis. Paying emphasis to prevention and treatment of intestinal dysfunction may reduce the infection of pancreatic necrotic tissue,preventing the progress of MODS and reducing the mortality rate of SAP. This article reviewed the pathogenic mechanism as well as prevention and treatment of intestinal dysfunction in SAP.