Kovács G C, Fürész J, Fekete L, Záborszky Z, Orgován G, Kollár E, Regöly-Mérei J
MH Központi Honvédkórház, Budapest, Altalános Sebészeti Osztály.
Orv Hetil. 1999 Apr 25;140(17):941-5.
Based on the literature dysfunction of splanchnic circulation may be assumeol in the development of severe acute pancreatitis. Abnormal gut functions investigated by routinely used clinical examination is not available. Gastric tonometry indirectly gives information about gut function. Authors followed prospectively 12 patients who suffered from acute pancreatitis. Four patients recovered without complications, 4 patients had different complications and 4 patients died. Gastric intramucosal pH (pHi) was measured by TRIP NGS catheter and Tonocap monitor. Measurements were started at the time of hospitalisation and repeated every six hours on the first 3 days. Intramucosal acidosis (pHi < 7.3) could be measured independently from aetiology. Gastric pHi showed strong correlation with Acute Physiology and Chronic Health Evaluation II. (APACHE II) score (p = 0.02). APACHE II scores were significantly higher in-group pHi < 7.2 (13.9 +/- 1.7) compared to group pHi > 7.2 (7.33 +/- 1.06) (p = 0.002). 24-hour changes in APACHE II scores were significantly greater in the cases of pHi < 7.2 (3.3 +/- 1.47) versus pHi > 7.2 (-0.6 +/- 0.97) (p = 0.03). Changes of pHi in the early phase of acute pancreatitis indicate that splanchnic circulation is already involved and the pHi may have a prognostic value.
基于文献，内脏循环功能障碍可能被认为在重症急性胰腺炎的发展过程中起作用。通过常规临床检查所研究的肠道功能异常情况并不明确。胃张力测定法可间接提供有关肠道功能的信息。作者前瞻性地追踪了12例急性胰腺炎患者。4例患者康复且无并发症，4例患者出现不同并发症，4例患者死亡。采用TRIP NGS导管和Tonocap监测仪测量胃黏膜内pH值（pHi）。测量从住院时开始，在头3天每6小时重复一次。黏膜内酸中毒（pHi < 7.3）可独立于病因进行测量。胃pHi与急性生理与慢性健康状况评分系统II（APACHE II）评分呈强相关性（p = 0.02）。与pHi > 7.2组（7.33 ± 1.06）相比，pHi < 7.2组的APACHE II评分显著更高（13.9 ± 1.7）（p = 0.002）。在pHi < 7.2的病例中，APACHE II评分的24小时变化（3.3 ± 1.47）显著大于pHi > 7.2的病例（-0.6 ± 0.97）（p = 0.03）。急性胰腺炎早期pHi的变化表明内脏循环已受累，且pHi可能具有预后价值。
