Sato N
Department of Surgery, Dokkyo University School of Medicine, Mibu, Japan.
Nihon Geka Gakkai Zasshi. 1992 Aug;93(8):784-93.
This study was undertaken to investigate the incidence of postoperative hyperamylasemia and amylase levels of intraperitoneal drainage in 106 patients undergoing major abdominal surgery. The results were as follows: 1. Postoperative hyperamylasemia was found in 36.8% of all patients, with higher incidence of hyperamylasemia being in accordance with greater surgical intervention to the pancreas. 2. The isoamylase pattern of postoperative hyperamylasemia was dominant in the salivary type. 3. The levels of such serum pancreatic enzymes as lipase, trypsin and elastase 1 were higher in the pancreatic-type group than in the salivary-type group, particularly with the elastase 1 levels being statistically higher in the former. 4. Increases in peritoneal amylase activity were found in those cases of greater surgical intervention to the pancreas, postoperative hyperamylasemia and higher serum pancreatic isoamylase levels. 5. Diagnosis of postoperative pancreatitis was confirmed in one case by clinical and laboratory findings and CT examination. It might be concluded that postoperative high peritoneal amylase levels suggest occurrence or possible occurrence of postoperative pancreatitis.
本研究旨在调查106例接受腹部大手术患者术后高淀粉酶血症的发生率及腹腔引流液淀粉酶水平。结果如下:1. 所有患者中36.8%出现术后高淀粉酶血症,胰腺手术干预程度越大,高淀粉酶血症发生率越高。2. 术后高淀粉酶血症的同工酶谱以唾液型为主。3. 胰腺型组血清脂肪酶、胰蛋白酶和弹性蛋白酶1等胰腺酶水平高于唾液型组,尤其是弹性蛋白酶1水平在前者中具有统计学意义上的更高值。4. 在胰腺手术干预程度较大、术后高淀粉酶血症及血清胰腺同工酶水平较高的病例中,发现腹腔淀粉酶活性增加。5. 通过临床、实验室检查及CT检查确诊1例术后胰腺炎。可以得出结论,术后腹腔淀粉酶水平升高提示术后胰腺炎的发生或可能发生。