持续区域动脉灌注治疗儿童重症急性坏死性胰腺炎1例报告

doi:10.12372/jcp.2026.25e0518

摘要/Abstract

摘要：

儿童急性胰腺炎（AP）发病率呈逐年上升趋势。目前儿童重症急性坏死性胰腺炎尚欠缺规范而标准的诊疗方案，临床工作中多借鉴和参考成人标准。药物的持续区域动脉灌注已在成人早期急性坏死性胰腺炎的治疗中被应用，但儿童AP的病因、病理生理过程及药代动力学不同于成人且存在一定的个体差异，针对儿童AP的相关报道甚少。文章报道了1例儿童重症急性坏死性胰腺炎通过持续区域动脉灌注治疗，由留置导管将药物注入指定部位的案例，并就儿童AP中持续区域动脉灌注治疗的适用性进行了探讨，以期促进儿童AP诊治的进步。

关键词: 重症急性坏死性胰腺炎, 持续区域动脉灌注, 儿童

Abstract:

The incidence of acute pancreatitis (AP) in children has shown a yearly increasing trend. Currently, standardized and definitive diagnosis and treatment protocols for severe acute necrotizing pancreatitis in children are lacking, and clinical practice often relies on adapting adult guidelines. Continuous regional arterial infusion of medication has been applied in the treatment of early-stage acute necrotizing pancreatitis in adults. However, the etiology, pathophysiological processes, and pharmacokinetics of AP differ in children compared to adults, with certain individual variations also present. Consequently, reports on its application specifically in children with AP are scarce. This article presents a case of severe acute necrotizing pancreatitis in a child treated via continuous regional arterial infusion, where medication was administered to a specified site through an indwelling catheter. Furthermore, the applicability of continuous regional arterial infusion therapy in pediatric AP is discussed, aiming to contribute to advancements in the diagnosis and management of AP in children.

Key words: severe acute necrotizing pancreatitis, continuous regional arterial infusion, child

中图分类号:

谢世宇, 郑敏讷, 刘春花, 王艳丽. 持续区域动脉灌注治疗儿童重症急性坏死性胰腺炎1例报告[J]. 临床儿科杂志, 2026, 44(4): 337-340.

XIE Shiyu, ZHENG Minne, LIU Chunhua, WANG Yanli. A case of severe acute necrotizing pancreatitis in children treated by continuous regional arterial infusion[J]. Journal of Clinical Pediatrics, 2026, 44(4): 337-340.

图/表 2

参考文献 15

[1]	Perdomo Muñoz JM, Morise S, Pallitto MB, et al. Recurrent acute pancreatitis in pediatrics: characteristics and risk factors[J]. Arch Argent Pediatr, 2025, 123(3): e202410437.
[2]	Tenner S, Vege SS, Sheth SG, et al. American College of Gastroenterology Guidelines: Management of Acute Pancreatitis[J]. Am J Gastroenterol, 2024, 119(3): 419-437.
[3]	Hirota M, Shimosegawa T, Kitamura K, et al. Continuous regional arterial infusion versus intravenous administration of the protease inhibitor nafamostat mesilate for predicted severe acute pancreatitis: a multicenter, randomized, open-label, phase 2 trial[J]. J Gastroenterol, 2020, 55(3): 342-352.
[4]	Mikami Y, Takeda K, Matsuda K, et al. Rat experimental model of continuous regional arterial infusion of protease inhibitor and its effects on severe acute pancreatitis[J]. Pancreas, 2005, 30(3): 248-253.
[5]	周蒙滔, 王春友. 重症急性胰腺炎两次病死高峰的综合救治[J]. 肝胆胰外科杂志, 2019, 31(1): 3-5.
	Zhou MT, Wang CY. Comprehensive treatment of the two mortality peaks in severe acute pancreatitis[J]. Gandanyi Waike Zazhi, 2019, 31(1): 3-5.
[6]	Piaścik M, Rydzewska G, Milewski J, et al. The results of severe acute pancreatitis treatment with continuous regional arterial infusion of protease inhibitor and antibiotic: a randomized controlled study[J]. Pancreas, 2010, 39(6): 863-867.
[7]	钟盛华, 危雪晖. 区域动脉灌注与静脉输注乌司他丁治疗重症急性胰腺炎的临床效果对比[J]. 中国医学创新, 2020, 17(18): 135-138.
	Zhong SH, Wei XH. Comparison of clinical effects between regional arterial infusion and intravenous infusion of ulinastatin in the treatment of severe acute pancreatitis[J]. Zhongguo Yixue Chuangxin, 2020, 17(18): 135-138.
[8]	安文慧, 杨婧, 何旭昶, 等. 持续区域动脉灌注联合不同药物治疗重症急性胰腺炎的研究[J]. 胃肠病学和肝病学杂志, 2020, 29(4): 384-387.
	An WH, Yang J, He XC, et al. Study on continuous regional arterial infusion combined with different drugs in the treatment of severe acute pancreatitis[J]. Weichangbingxue He Ganbingxue Zazhi, 2020, 29(4): 384-387.
[9]	Fukushima H, Fukushima T, Suzuki R, et al. Continuous regional arterial infusion effective for children with acute necrotizing pancreatitis even under neutropenia[J]. Pediatr Int, 2013, 55(2): e11-e13.
[10]	Morimoto A, Imamura T, Ishii R, et al. Successful management of severe L-asparaginase-associated pancreatitis by continuous regional arterial infusion of protease inhibitor and antibiotic[J]. Cancer, 2008, 113(6): 1362-1369.
[11]	Portelli M, Jones CD. Severe acute pancreatitis: pathogenesis, diagnosis and surgical management[J]. Hepatobiliary Pancreat Dis Int, 2017, 16(2): 155-159.
[12]	Schietroma M, Pessia B, Carlei F, et al. Intestinal permeability and systemic endotoxemia in patients with acute pancreatitis[J]. Ann Ital Chir, 2016, 87: 138-144.
[13]	Wang X, Xu J, Li J, et al. Effect of regional arterial infusion combined with early enteral nutrition on severe acute pancreatitis[J]. J Int Med Res, 2019, 47(12): 6235-6243.
[14]	Poropat G, Giljaca V, Hauser G, et al. Enteral nutrition formulations for acute pancreatitis[J]. Cochrane Database Syst Rev, 2015, 2015(3): CD010605.
[15]	楼金玕. 儿童胰腺炎的营养管理[J]. 中国实用儿科杂志, 2022, 37(10): 732-736.
	Lou JG. Nutritional management of pancreatitis in children[J]. Zhongguo Shiyong Erke Zazhi, 2022, 37(10): 732-736.