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[重症胰腺炎的病理生理学与治疗]

[Pathophysiology and treatment of severe pancreatitis].

作者信息

Koh I, Satake K, Umeyama K

出版信息

Nihon Geka Gakkai Zasshi. 1985 Sep;86(9):1249-52.

PMID:4088246
Abstract

The current study was designed to characterize toxic substances in hemorrhagic ascitic fluid by using in vivo dogs model and to examine the toxicity of hemorrhagic ascitic fluid by using an in vivo mice model injecting the fluid intraperitoneally. Our experiment showed that high levels of bradykinin, histamine and prostaglandin E were found in serum and in hemorrhagic ascitic fluid which reported as toxic substances during severe pancreatitis. A similar finding was also obtained clinically in four patients with severe acute pancreatitis. The mortality rate on 72 hours following the intraperitoneal injection of 2.0 and 3.0 ml of ascitic fluid were 66.0% and 89.7% respectively. Mice which died following the injection of ascitic fluid showed shock lung at autopsy. These results indicate that peritoneal lavage might be an effective method for the treatment of severe pancreatitis. We evaluated 25 patients with severe acute pancreatitis clinically. Laparotomy and drainage operations were performed in 16 patients of these patients. Twelve among 16 patient had good results. The cause of death were multiorgan failures.

摘要

本研究旨在通过体内犬模型表征出血性腹水中的有毒物质,并通过向体内小鼠模型腹腔注射该腹水来检测出血性腹水的毒性。我们的实验表明,在血清和出血性腹水中发现了高水平的缓激肽、组胺和前列腺素E,这些在重症胰腺炎期间被报道为有毒物质。在4例重症急性胰腺炎患者中临床上也获得了类似的发现。腹腔注射2.0和3.0毫升腹水后72小时的死亡率分别为66.0%和89.7%。注射腹水后死亡的小鼠尸检显示有休克肺。这些结果表明腹腔灌洗可能是治疗重症胰腺炎的有效方法。我们对25例重症急性胰腺炎患者进行了临床评估。其中16例患者进行了剖腹手术和引流手术。16例患者中有12例效果良好。死亡原因是多器官衰竭。

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