重症急性胰腺炎（SAP）常合并腹腔高压（IAH），但只有少数会发生腹腔间隔室综合征（ACS）。SAP合并ACS的发生率低，但病死率极高，其发生有特殊的病理生理机制和临床特点。临床上需要对SAP合并IAH或ACS进行鉴别，并分别采取不同的治疗策略。SAP合并IAH无需特殊处理。SAP合并ACS病情严重，应采取积极的救治措施。SAP早期合并ACS病人开腹减压手术选择要相当慎重，而迟发型ACS因开腹减压的同时能去除病因，往往可以取得较好的效果。

Correctly understanding and handling of severe acute pancreatitis complicated with intra-abdominal hypertension and abdominal compartment syndrome                 YANG Zhi-yong, WANG Chun-you. Pancreatic Disease Research Institute, Union Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan430022，China
Correponding author: WANG Chun-you, E-mail: chunyouwang52@126.com
Abstract    Most of patients with severe acute pancreatitis (SAP) are complicated with intra-abdominal hypertension (IAH), and a few of them will progress to abdominal compartment syndrome (ACS) which is with very high mortality. ACS in SAP patients put up characteristic pathophysiological changes and clinical features. Doctors need distinguish between IAH and ACS, and then choose different therapeutic strategy. SAP complicated with IAH need not specific treatment. Intensive therapeutic efforts are necessary in SAP complicated with ACS. The decompressive laparotomy should be chosen cautiously to treat ACS in early stage of SAP. Delayed ACS in SAP patients usually get good outcome through the decompressive laparotomy because doctors can get rid of the etiological factors simultaneously.