Olsen Ole, Schulze Svend
Kirurgisk afdeling D, gastroenterologisk sektion, Amtssygehuset i Glostrup.
Ugeskr Laeger. 2002 Oct 21;164(43):5032-5.
The first international evidence-based guidelines for the management of acute pancreatitis were published in 1998. The aim of this study was to compare the care giving to patients with these guidelines.
During the period, June 1996 to May 1999, a survey was carried out of all patients with acute pancreatitis six months after discharge.
One hundred and fifty-five patients with a first attack were identified within 48 hours (goal: 100%). Fifty (32%) had gallstones identified. Fifty-one (32%) were severe cases with ten (20%) deaths (goal: < 30%). The overall mortality (6.4%) was within the goal of less than 10%. Objective severity stratification (Ranson scoring) was performed in 94% (goal: 100%), and in severe cases 82% (goal: 100%) had a CT. In severe gallstone pancreatitis, 90% (goal: 100%) underwent an early ERCP (< 72 hours after admission). One management goal was not met: in mild cases, only 20-25% (goal: 100%) with gallstone pancreatitis were given definitive treatment within four weeks.
The treatment we offer our patients with acute pancreatitis is optimal--apart from one standard--when compared with international guidelines, but in spite of this exception the mortality rate is low.
1998年发布了首份关于急性胰腺炎管理的国际循证指南。本研究的目的是将为患者提供的护理与这些指南进行比较。
在1996年6月至1999年5月期间，对所有急性胰腺炎患者出院6个月后进行了调查。
在48小时内确定了155例首次发作的患者（目标：100%）。其中50例（32%）被诊断为胆结石。51例（32%）为重症病例，10例（20%）死亡（目标：<30%）。总体死亡率（6.4%）在低于10%的目标范围内。94%的患者进行了客观严重程度分层（兰森评分）（目标：100%），重症病例中82%（目标：100%）进行了CT检查。在重症胆结石性胰腺炎中，90%（目标：100%）接受了早期内镜逆行胰胆管造影（入院后<72小时）。有一个管理目标未达成：在轻症病例中，胆结石性胰腺炎患者只有20 - 25%（目标：100%）在四周内接受了确定性治疗。
与国际指南相比，我们为急性胰腺炎患者提供的治疗除了一个标准外是最优的，但尽管有这个例外，死亡率仍然很低。
