アブストラクト
Japanese
| Title | 急性膵炎の初期治療 - 早期経腸栄養, 予防的抗菌薬投与, 局所動注療法 - |
|---|---|
| Subtitle | 〔特集〕急性膵炎診療ガイドライン2021 |
| Authors | 土谷飛鳥* |
| Authors (kana) | |
| Organization | *東海大学医学部医学科総合診療学系救命救急医学 |
| Journal | 膵臓 |
| Volume | 37 |
| Number | 5 |
| Page | 229-238 |
| Year/Month | 2022 / |
| Article | 報告 |
| Publisher | 日本膵臓学会 |
| Abstract | 要旨: 急性膵炎の初期治療法は, この10〜15年間でパラダイムシフトを迎えた. 経腸栄養に関して, 長い絶食期間が推奨されていたが, 近年, 世界のガイドラインは早期経腸栄養開始を推奨するようになった. 早期に腸管を使用することが予後改善に貢献するというエビデンスが蓄積されてきたためである. また, 予防的抗菌薬投与に関して, 重症膵炎においては長年投与が推奨されてきたが, 世界および日本の最新版ガイドラインでも投与は非推奨となった. さらに蛋白分解酵素阻害薬・抗菌薬膵局所動注療法に関しても, ガイドラインでは臨床研究の位置づけであり推奨していない. このように世界・日本においても大きく潮流が変化している. 従って, 急性膵炎の初期治療に臨むすべての職種には, まずは日本のガイドライン推奨を遵守することが求められ, その上で, ガイドラインや関係学会に求められることは, 推奨内容の啓蒙と疫学的横断研究調査を繰り返すことである. |
| Practice | 臨床医学：内科系 |
| Keywords | 早期経腸栄養, 予防的抗菌薬, 局所動注療法, ガイドライン, Early enteral nutrition, Prophylactic antibiotics, Regional arterial infusion, Guideline |
English
| Title | Initial treatment of acute pancreatitis - Early enteral nutrition, prophylactic antimicrobials, and regional arterial infusion - |
|---|---|
| Subtitle | |
| Authors | Asuka TSUCHIYA* |
| Authors (kana) | |
| Organization | *Department of Emergency and Critical Care Medicine, Tokai University School of Medicine |
| Journal | Journal of the Japan Pancreas Society |
| Volume | 37 |
| Number | 5 |
| Page | 229-238 |
| Year/Month | 2022 / |
| Article | Report |
| Publisher | Japan Pancreas Society |
| Abstract | The initial treatment of patients with acute pancreatitis has undergone a paradigm shift in the last 10 - 15 years. Regarding enteral nutrition, long periods of fasting were recommended, but in recent years, guidelines in the world and Japan recommend early initiation of enteral nutrition. Evidence has accumulated that early enteral nutrition contributes to an improved prognosis. In addition, prophylactic administration of antibiotics has long been recommended for patients with severe pancreatitis, but the latest editions of guidelines for acute pancreatitis have deprecated the use of such agents. Furthermore, the guidelines do not recommend regional arterial infusion of protease inhibitors and antibiotics in the pancreas. As described above, the trend is changing drastically in Japan and the rest of the world. Therefore, all professionals involved in the initial treatment of acute pancreatitis must comply with the recommendations of the Japanese guidelines. In addition, the guidelines and their sponsoring academic societies must educate the public about the recommendations and repeat cross-sectional epidemiological studies. |
| Practice | Clinical internal medicine |
| Keywords | Early enteral nutrition, Prophylactic antibiotics, Regional arterial infusion, Guideline |
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残りの26件を表示する
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