Novosti
|
This journal is indexed in Scopus |
|---|
Year 2012 Vol. 20 No 4
GENERAL AND SPECIAL SURGERY
YU.S. VINNIK, S.S. DUNAEVSKAYA, D.A. ANTUFRIEVA
RISK OF COMPLICATIONS DEVELOPMENT AT ALCOHOL-RELATED ACUTE PANCREATITIS
State Budgetary Educational Establishment of Higher Professional Education “Krasnoyarsk State Medical University named after Professorv.F.Voyno-Yasenetsky”
The Russian Federation
Objectives. To work out a prognostic method of development of a severe alcohol-related acute pancreatitis on the basis of dynamics of the laboratory diagnostics parameters.
Methods. 75 patients with the diagnosed alcohol-related acute pancreatitis were under our observation. All patients were receiving a conventional therapy. The age of the majority of patients with acute pancreatitis was from 23 up to 76 years. On the basis of the detailed blood analysis the following parameters were calculated: reactive response of neutrophils (RRN), ratio index of the segmented neutrophils to lymphocytes (ISL); the level of the urine diastasis was also taken into account (LUD).
Results. Risk estimation of the complications development was carried out according to the parameters dynamics: reactive response of neutrophils (RRN), ratio index of the segmented neutrophils to lymphocytes (ISL); the level of the urine diastasis (LUD). In obtaining 2 out of 3 positive values of the above mentioned parameters one could make a conclusion about high probability of a severe course.
There were no lethal outcomes in the group with low risk of complications development; the average period of hospitalization made up 8,79±0,9 days. While predicting a severe course, destructive forms of acute pancreatitis developed in 94,12% cases; lethality made up 48%. The average term of hospitalization for the given group of patients made up 40,46±2,5. So, at revealing a high risk of severe acute pancreatitis development it is recommended to administer intensive starting therapy (concept of “abort of pancreatonecrosis”)
Conclusions. The correlation between the clinical course of the disease and dynamics of the changes in the laboratory diagnostics parameters has been proved. The suggested express-method to estimate the risk of the complications development in patients with acute pancreatitis of alcohol etiology is characterized by high specificity and negative prognostic significance.
1. Beskosnyi AA, Kasum'ian SA. Kriterii prognoza tiazhelogo techeniia ostrogo pankreatita [Prediction criteria of severe acute pancreatitis]. Annaly Khirurg Gepatologii. 2003;1:24–32.
2. Sand J, Lankisch PG, Nordback I. Alcohol consumption in patients with acute or chronic pancreatitis. Pancreatology. 2007;7:147–56.
3. Imrie C. Prognosis of acute pancreatitis. Ann Ital Chir. 1995;66(2):187–89.
4. Savel'ev VS, Filimonov MI, Burnevich SZ. Voprosy klassifikatsii i khirurgicheskogo lecheniia pri pankreonekroze [Some aspects of classification and surgical treatment of necrotizing pancreatitis]. Annaly Khirurgii. 1999;(4):34–38.
5. Filin VI, Kostiuchenko AL. Neotlozhnaia pankreatologiia [Emergency pancreatology]. Saint Petersburg, RF: Piter, 1994. 410 p.
6. Bagnenko SF, Bagnenko SF, Tolstoi AD, Gol'tsov VR. Protokoly diagnostiki i lecheniia ostrogo pankreatita na raznykh stadiiakh zabolevaniia [Protocols of the diagnosis and treatment of acute pancreatitis at different stages of the disease] Neotlozhnaia i spetsializirovannaia khirurgicheskaia pomoshch'. Мoscow, RF: 2005. p. 84–85.
7. Knaus WA, Draper EA, Wagner DP. APACHE II. A severity of disease classification system. Crit Care Med. Oct;13(10):818–29.
8. Karabanov GN. Ispol'zovanie leikotsitarnoi formuly krovi dlia otsenki tiazhesti intoksikatsii [The use of blood leukocyte count to assess the severity of intoxication]. Vestn Khirurgii. 1989;(4):146–49.
660022, Rossiyskaya FederatsiyaKrasnoyarsk, ul. Partizana Zheleznyaka, d. 1,GBOU VPO «Krasnoyarskiygosudarstvennyiy meditsinskiy universitetim. prof. V.F. Voyno-Yasenetskogo»,kafedra obschey hirurgii,
e-mail: Vikto-potapenk@yandex.ru,
Dunaevskaya Svetlana Sergeevna
Vinnik YU.S.Honored Scientist of Russia Doctor of medical sciences, Professor, Head of the general surgery chair of SBEE HPE «Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky".
Dunaevskaya S.S. Candidate of medical sciences, Associate Professor of the General Surgery Chair of of SBEE HPE «Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky "
Antyufrieva D.A. Clinical Resident of the General Surgery Chair of SBEE HPE «Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky".
Article in the .pdf format
