Abstract:

 The mortality rate among patients with secondary infection and severe acute pancreatitis （SAP） remains high.A variety of factors lead to intestinal barrier dysfunction along with bacterial translocation of the intestine，thus making necrotic pancreatic tissue and peripancreatic tissue susceptible to secondary infection.Patients with high-risk secondary infection can be identified through indicators based on patient complications，treatment measures and laboratory tests.For patients likely to have secondary infection，early enteral nutrition and rational use of antibiotics can reduce the incidence of infection.However，probiotic treatments for secondary infections remain controversial regarding their effectiveness and safety.In addition，intestinal decontamination and surgical intervention play important roles in preventing secondary infections.This article summarizes the pathogenesis，risk factors，early diagnosis and preventive methods of SAP secondary infection through reviewing the relevant literature，to provide clinicians with new ideas for diagnosis and treatment.

Key words: Pancreatitis, acute necrotizing；Secondary infection；Early diagnosis；Prevention

摘要： 重症急性胰腺炎（SAP）继发感染患者病死率居高不下。多种因素导致肠道屏障功能障碍加之肠道细菌移位，使坏死的胰腺及胰周组织易继发感染。结合患者存在的合并症、采取的治疗措施及实验室检查等指标可识别继发感染的高危患者。针对可能继发感染的患者，应尽早给予肠内营养、合理运用抗生素，从而减少继发感染的发生，而益生菌对于预防继发感染的有效性及安全性仍存在争议，肠道去污及外科干预也对预防继发感染具有重要作用。本文通过查阅相关文献，对SAP继发感染的发病机制、危险因素、早期诊断及预防方法等进行综述，以期为临床医生提供诊治新思路。

关键词: 胰腺炎, 急性坏死性；继发感染；早期诊断；预防