Pierrakakis S, Xepapadakis G, Mega A M, Megas T, Katergiannakis V G, Perpirakis G, Filippakis M
Clinica Chirurgica Sismanoglion, Ospedale Generale, Atene.
Minerva Chir. 1990 Mar 15;45(5):295-301.
Forty-five cases of acute pancreatitis observed during the period 1986-88 were included in this study. Four of the 45 patients were operated during the acute phase and of these, two died. The remaining 41 patients were treated with conservative therapy using the application of a nasogastric tube, analgesics, and the endovenous administration of various solutions and antibiotics. The severity of each attack of pancreatitis was assessed according to Ranson and Agarwal's criteria. In severe cases (more than 3 of Ranson's criteria) the presence of endotoxin in the systemic circulation was shown using the "limulus" method, together with contemporary low levels of C3 complement factor. As is evident from the results of the study, the presence of endotoxinemia and the low level of C3 in acute pancreatitis are related to the high percentage of complications.
本研究纳入了1986年至1988年期间观察到的45例急性胰腺炎病例。45例患者中有4例在急性期接受了手术,其中2例死亡。其余41例患者采用保守治疗,包括使用鼻胃管、镇痛药以及静脉输注各种溶液和抗生素。根据兰森(Ranson)和阿加瓦尔(Agarwal)的标准评估每次胰腺炎发作的严重程度。在严重病例(兰森标准超过3项)中,采用“鲎试剂”法检测全身循环中内毒素的存在,同时检测到补体C3因子水平较低。从研究结果可以明显看出,急性胰腺炎中内毒素血症的存在和C3水平降低与并发症的高发生率有关。