急性胆源性胰腺炎诊治研究进展

Research Progress in Diagnosis and Treatment of Acute Biliary Pancreatitis

摘要: 急性胆源性胰腺炎(Acute Biliary Pancreatitis, ABP)是临床最常见的急性胰腺炎(Acute Pancreatitis, AP)类型，占所有AP病例的30%~60%，具有起病急、进展快、并发症多、病死率高的特点。随着微创技术、精准医学理念及护理模式的发展，ABP诊疗策略显著优化。本文系统综述ABP的流行病学与病因学特征(如我国华北地区ABP占比53.7%，女性发病率高于男性)、发病机制(以“共同通道学说”为核心，分子层面涉及NF-κB、TLR4等炎症信号通路激活)、诊断策略(影像学联合新型生物标志物如NLR、PCT)、治疗进展(内科基础治疗、内镜介入、外科手术)，并探讨老年特殊人群管理及优质护理的应用价值。研究表明，ABP诊疗已进入微创、精准、个体化时代，未来需通过多学科协作进一步提升诊治水平。

Abstract: Acute Biliary Pancreatitis (ABP) is the most common type of Acute Pancreatitis (AP) in clinical practice, accounting for 30%~60% of all AP cases [1]. It is characterized by acute onset, rapid progression, multiple complications, and high mortality. With the development of minimally invasive technology, the concept of precision medicine, and nursing models, the diagnosis and treatment strategies for ABP have been significantly optimized. This article systematically reviews the epidemiological and etiological characteristics of ABP (e.g., ABP accounts for 53.7% of AP cases in North China, China, and the incidence rate in women is higher than that in men), pathogenesis (centered on the “common channel theory,” involving the activation of inflammatory signaling pathways such as NF-κB and TLR4 at the molecular level), diagnostic strategies (combination of imaging and new biomarkers such as NLR and PCT), treatment progress (basic medical treatment, endoscopic intervention, surgical operation), and discusses the management of special elderly populations and the application value of high-quality nursing. Studies have shown that the diagnosis and treatment of ABP have entered an era of minimally invasive, precise, and individualized practice, and multi-disciplinary collaboration is needed to further improve the level of diagnosis and treatment in the future.