Veronskiĭ G I, Viskunov V G
Khirurgiia (Mosk). 1993 Jul(7):17-21.
After operation on the stomach in 1,602 patients (3.9% mortality) acute postoperative pancreatitis (APP) developed in 60 of them. Twenty patients died from APP. The impulsive pain symptom and diastasuria were characteristic of the clinical picture in 35 patients. According to the severity of the impulsive pain, the diastasis level in the urine, and the complex of therapeutic measures needed to arrest the developing APP, three degrees of ductal hypertension were distinguished. There were no deaths among patients with APP of the first degree. In 23 patients APP was marked by manifest intoxication from the first postoperative day and subsequent development of many complications which called for reoperations. In this group 18 patients died. In 2 cases APP was distinguished by a rapid course and fulgurant development. Attention was drawn from the very beginning to the extreme severity of the patients' condition. Symptoms of shock prevailed in the clinical picture. Both patients died. The authors suggest a scheme of APP prevention with the use of aldehydes, antioxidants, inhibitors of proteolytic enzymes, a complex of vitamins.
在1602例接受胃部手术的患者中（死亡率为3.9%），其中60例发生了急性术后胰腺炎（APP）。20例患者死于APP。35例患者的临床表现以突发性疼痛症状和尿淀粉酶增高为特征。根据突发性疼痛的严重程度、尿液中淀粉酶的增高程度以及阻止APP发展所需的综合治疗措施，区分出三度导管高压。一度APP患者无死亡病例。23例患者术后第一天即出现明显中毒症状，随后出现许多并发症，需要再次手术。该组18例患者死亡。2例APP患者病情发展迅速且呈暴发性。从一开始就注意到患者病情极其严重。临床表现以休克症状为主。两名患者均死亡。作者提出了一种使用醛类、抗氧化剂、蛋白水解酶抑制剂、复合维生素来预防APP的方案。
