Teerenhovi O, Nordback I, Eskola J
Department of Surgery, Tampere University, Finland.
Br J Surg. 1989 Apr;76(4):370-3. doi: 10.1002/bjs.1800760418.
The effect of lesser sac drainage with or without lavage on some early predictors and on outcome in acute necrotizing pancreatitis was analysed. The evaluation was made prospectively for 24 patients, in a single centre study. According to Ranson's criteria and laparotomy findings, the lavage and drainage groups were comparable and the pancreatitis was severe and necrotizing in both groups. In a longitudinal analysis of the first 4 postoperative days, lavage did not show any advantage over drainage, as measured by seven prognostic signs (serum creatinine, blood glucose, base excess, haematocrit, white blood cells, C-reactive protein and immunoreactive phospholipase A2 concentration). Furthermore, the study did not find that lavage had any positive effect on the incidence of mortality (36 versus 17 per cent in the drainage group) or on septic complications in acute necrotizing pancreatitis. In the total series the extent of pancreatic necrosis was an essential predictor of the outcome.
分析了小网膜囊引流（伴或不伴灌洗）对急性坏死性胰腺炎的一些早期预测指标及预后的影响。在一项单中心研究中，对24例患者进行了前瞻性评估。根据兰森标准和剖腹探查结果，灌洗组和引流组具有可比性，两组胰腺炎均为重症且坏死性。在对术后头4天的纵向分析中，通过七个预后指标（血清肌酐、血糖、碱剩余、血细胞比容、白细胞、C反应蛋白和免疫反应性磷脂酶A2浓度）衡量，灌洗并未显示出比引流有任何优势。此外，该研究未发现灌洗对急性坏死性胰腺炎的死亡率（引流组为36%，灌洗组为17%）或感染性并发症发生率有任何积极影响。在整个系列研究中，胰腺坏死程度是预后的重要预测指标。
