基于严重程度评分的急性胰腺炎治疗方案选择的前瞻性研究。

Prospective study of a protocol for selection of treatment of acute pancreatitis based on scoring of severity.

作者信息

Yokoi H, Naganuma T, Higashiguchi T, Isaji S, Kawarada Y

机构信息

First Department of Surgery, Mie University School of Medicine, Mie, Japan.

出版信息

Digestion. 1999;60 Suppl 1:14-8. doi: 10.1159/000051447.

DOI:10.1159/000051447

PMID:10026425

Abstract

BACKGROUND/AIM: Since July 1994, we have been conducting a prospective study of a protocol for selection of treatment of acute pancreatitis based on scoring of severity.

METHODS

From July 1994 to June 1998, 56 patients with acute pancreatitis were enrolled in this study. The protocol employed was based on the results of our retrospective study. On admission, the prognosis score (scoring of severity of acute pancreatitis based on the criteria of the Ministry of Health and Welfare of Japan) and APACHE II score were calculated, and early treatment was selected according to the protocol.

RESULTS

All of the 26 patients with gallstone pancreatitis and 28 of 30 patients with non-gallstone pancreatitis were successfully treated and had good outcome. There were 2 deaths in non-gallstone pancreatitis. In selection of early treatment according to the scoring of severity, we suggested that when the prognosis score is 2 or more and the APACHE II score of 8 or more, gallstone pancreatitis should be treated by biliary drainage, and non-gallstone pancreatitis by peritoneal lavage. When infected pancreatic necrosis is exhibited, surgery is indicated.

CONCLUSION

Our new management protocol for acute pancreatitis based on the prognosis score and APACHE II score appear to be useful for accurately scoring severity and selecting the treatment methods.

摘要

背景/目的：自1994年7月起，我们一直在进行一项前瞻性研究，该研究基于严重程度评分制定急性胰腺炎治疗选择方案。