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[急性胰腺炎预后系统的开发]

[Development of prognostic systems in acute pancreatitis].

作者信息

Wojtuń Stanisław, Gil Jerzy, Jałocha Lukasz

机构信息

Wojskowy Instytut Medyczny w Warszawie, Klinika Gastroenterologii CSK MON.

出版信息

Pol Merkur Lekarski. 2007 May;22(131):460-4.

Abstract

Acute pancreatitis is an illness of unpredictable course and in order to implement optimal treatment requires quick assessment of its probable severity and course. The development of prognostic systems was caused to determine patients of high risk of severe course of the illness, that require intensive care and proper treatment. This is the reason of development of prognostic systems based on clinical criteria, lab results and imaging procedures. Yet, none of them does fulfill all requirements. In the paper author presented and evaluated the clinical usefulness of various methods of predicting the course of pancreatitis in historical view. Although commonly used are multifactor clinical scales, current literature shows changing requirements to any scale evaluating the illness that come from better knowledge of biological mechanisms and technological development. Yet still commonly used are simple and and of practical use in any hospital ward multifactor scale with additional C-reactive protein assessment. Based on these there is high probability of correct assessment the future course of acute pancreatitis within 48 hours. Important element of evaluation of pancreatitis is current level of morphological distortion and pancreatic necrosis with use of computed tomography with contrast used in CTS index. The ultimate outcome of our assesment would be the result of the treatment of acute pancreatitis that is dependant on the skill of predicting the severity of illness course and in the end optimal treatment of the patient

摘要

急性胰腺炎是一种病程难以预测的疾病,为了实施最佳治疗,需要快速评估其可能的严重程度和病程。预后系统的发展旨在确定疾病严重病程的高危患者,这些患者需要重症监护和适当治疗。这就是基于临床标准、实验室结果和影像学检查开发预后系统的原因。然而,它们都不能满足所有要求。作者在文中从历史角度介绍并评估了预测胰腺炎病程的各种方法的临床实用性。虽然常用的是多因素临床量表,但当前文献表明,由于对生物学机制的深入了解和技术发展,对评估该疾病的任何量表的要求都在不断变化。然而,简单且在任何医院病房都实用的多因素量表加上C反应蛋白评估仍被广泛使用。基于这些,在48小时内正确评估急性胰腺炎未来病程的可能性很大。评估胰腺炎的一个重要因素是使用CTS指数中带造影剂的计算机断层扫描来确定当前形态学扭曲和胰腺坏死的程度。我们评估的最终结果将是急性胰腺炎的治疗结果,这取决于预测疾病病程严重程度的能力,最终取决于对患者的最佳治疗。

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