肝胆胰外科杂志2026，Vol.38Issue(9)：662-667,6.DOI:10.11952/j.issn.1007-1954.2026.09.009
重症急性胰腺炎合并多器官功能衰竭及多重耐药菌感染一例
Severe acute pancreatitis complicated with multiple organ dysfunction syndrome and multidrug-resistant bacterial infection:A case report
摘要
Abstract
This study reported the diagnosis and treatment of a patient with severe acute pancreatitis(SAP)complicated by multiple organ failure,multidrug-resistant bacterial infection,and complex abdominal complications.A 36-year-old male patient was admitted to the First Affiliated Hospital,Zhejiang University School of Medicine on Feburary 19,2024 due to sudden abdominal pain for 11 days after alcohol intake.He was diagnosed with severe acute pancreatitis at a local hospital and subsequently developed acute respiratory failure,septic shock,acute kidney injury,and severe cholestatic liver injury.After transfer to our hospital,the patient received mechanical ventilation,hemodynamic support,continuous renal replacement therapy,anti-infective and antifungal therapy,nutritional support,and multi-site drainage.During hospitalization,carbapenem-resistant Acinetobacter baumannii,carbapenem-resistant Pseudomonas aeruginosa,Candida albicans,Enterococcus faecium,and Klebsiella aerogenes were detected in sputum,ascites,blood,and catheter cultures.The anti-infective regimen was adjusted according to infection sites,culture results,and antimicrobial susceptibility testing.The patient later developed abdominal hemorrhage,necrotic tissue accumulation,intestinal fistula and bile leakage,and underwent abdominal debridement and drainage,total intra-abdominal colectomy,distal pancreatectomy,total splenectomy,ileostomy,and repeated abdominal debridement and drainage.After multidisciplinary treatment,the patient's infection and organ function improved,his circulatory status became stable,and bedside rehabilitation and respiratory function training were initiated on May 15,2024.The patient was discharged on August 22,2024 after improvement of the condition.This case suggestted that infection source control,individualized anti-infective therapy,timely surgical intervention,organ support,nutritional support,and rehabilitation management should be emphasized in patients with SAP complicated by complex infection and multiple organ failure.关键词
重症急性胰腺炎/多器官功能衰竭/多重耐药菌/腹腔感染/外科干预Key words
severe acute pancreatitis/multiple organ failure/multidrug-resistant bacteria/abdominal infection/surgical intervention分类
医药卫生引用本文复制引用
赵瑞金,荚杨洋,王国彬,俞文桥,朱悦..重症急性胰腺炎合并多器官功能衰竭及多重耐药菌感染一例[J].肝胆胰外科杂志,2026,38(9):662-667,6.基金项目
国家科技重大专项青年科学家项目(2025ZD0549000). （2025ZD0549000）
