Martínez J, Zúñiga A, Guzmán S, Llanos O, Rahmer A, Troncoso P, Escobar M
Servicio de Cirugía, Hospital Clínico P Universidad Católica de Chile, Santiago.
Rev Med Chil. 1991 Jun;119(6):659-69.
Sixty-three patients with severe acute pancreatitis have been studied. Pancreatitis was associated with biliary tract disease in 23 patients (36.5%) and with alcoholism in 21 (33.3%). It occurred post-operatively in 9, and was associated with other conditions in 10. We evaluated the Ranson prognostic signs (RPS) with the appearance of complications. 36 patients (57.2%) had 3-4 RPS, 9 (30.2%) had 5-6 RPS and 8 (12.6%) had 7 or more RPS. Diagnostic laparotomy was performed in 11 patients (17.5%). 55 patients were operated one or more times due to failure of medical treatment and/or local and septic complications. The most frequent complications were pancreatic abscess (60.3%), sepsis (58.7%) and pulmonary insufficiency (52.4%). Renal failure occurred in 26 patients and 9 required dialysis. Of the patients with renal failure, 84.6% (22/26) had 4 or more RPS; 78.4% (29/37) of those with sepsis and 71.6% (27/38) of those with pancreatic abscess also had 4 or more RPS. The mean duration of hospitalization of survivors was 58 +/- 30 days. Overall mortality was 28.6%. We conclude that RPS are helpful to predict complications in patients with severe pancreatitis.
对63例重症急性胰腺炎患者进行了研究。23例（36.5%）胰腺炎与胆道疾病有关，21例（33.3%）与酗酒有关。9例术后发生胰腺炎，10例与其他疾病有关。我们根据并发症的出现评估了兰森预后指标（RPS）。36例（57.2%）患者有3 - 4个RPS，9例（30.2%）有5 - 6个RPS，8例（12.6%）有7个或更多RPS。11例患者（17.5%）进行了诊断性剖腹手术。55例患者因内科治疗失败和/或局部及感染性并发症接受了一次或多次手术。最常见的并发症是胰腺脓肿（60.3%）、脓毒症（58.7%）和肺功能不全（52.4%）。26例患者发生肾衰竭，9例需要透析。在肾衰竭患者中，84.6%（22/26）有4个或更多RPS；脓毒症患者中有78.4%（29/37）、胰腺脓肿患者中有71.6%（27/38）也有4个或更多RPS。存活患者的平均住院时间为58±30天。总体死亡率为28.6%。我们得出结论，RPS有助于预测重症胰腺炎患者的并发症。
