To evaluate the effects of different pressure and duration of autologous bile perfusion into dog’s pancreatic duct on the severity of induced acute pancreatitis. Thirty mongrel dogs were divided into five groups, with each group consisting of six dogs. Histological changes of pancreas were observed. Results: Histological changes of pancreas were correlated with the pressure and duration of autologous bile perfusion into pancreatic duct. It was easier to produce acute hemorrhagic necrotizing pancreatitis in the groups with a higher pressure and a longer duration of perfusion than in the groups with a lower pressure and a shorter duration. The results indicated that there was a significant effect of higher pressure and longer duration bile perfusion into pancreatic duct on the severity of induced acute pancreatitis.
Objective To investigate the efficiency of combining traditional Chinese medicine with western medicine in the treatment of severe acute pancreatitis (SAP). Methods The clinical results of sixty three cases of SAP of non-operative treatment with injection of Salia miltorrhizae composita, and oral or gastric tube feeding of decoction Qing-Yi-Tang were retrospectively studied. Results Thirty four cases were categorised as SAP Ⅰ grade, and 29 cases as SAP Ⅱ grade. A variety of complications occurred in 19 cases (30.16%), 3 patients died (4.76%), and 4 patients developing abscess of pancreas (6.35%) which had to be operated on.Conclusion The individualization principle on the basis of cause and clinical stage of the disease should be stressed in treating SAP. The patients who had complication needing to be operated on should be timely performed. There is a good efficiency in the treatment of SAP with the traditional Chinese medicine combining with western medicine.
ObjectiveTo summarize the changes and interaction of the cytokine in severe acute pancreatitis associated lung injury. MethodsThe published literatures at domestic and aboard in recent years about severe acute pancreatitis associated lung injury were collected and reviewed. ResultsThe cytokines had a chain effect, and influenced each other when severe acute pancreatitis with lung injury attacked. ConclusionsRelated cytokines play important roles in severe acute pancreatitis associated lung injury. Researching the related cytokines will contribute to the diagnosis and treatment for severe acute pancreatitis with lung injury.
ObjectiveTo determine the characters of symptomatic pancreatic pseudocyst due to acute pancreatitis and effects of surgical treatment with two kinds of procedure （internal drainage or external drainage）. MethodsOne hundred and fifteen cases hospitalized during recent ten years were retrospectively analyzed.ResultsWe found that necrotic tissue existed in the pseudocyst in most cases and infection might occur in these pseudocyst. Although effect of two kinds of surgery was similar, the clinical course was different. The complications after surgery were fewer in patients underwent internal drainage than that with procedure of external drainage, and average hospital day was 7d in cases with internal drainage and 11d in cases with external one respectively. Surgery of internal drainage used in treatment was not only successful in noninfectious and single pseudocyst, but in infectious or multiple seudocyst.ConclusionInternal drainage should be used in most cases and considered as the first selection in surgery of pseudocyst due to acute pancreatitis.
摘要:目的:探讨重症急性胰腺炎(SAP)继发感染的临床特点。方法:将我院20039~20053收治的SAP140例,按是否感染,分成感染组和对照组,对比分析其临床资料。结果:感染组病死率高于对照组(P=0023);感染组入院初期,Ranson评分、CT评分、APACHE Ⅱ评分、血糖、ARDS和肠麻痹发生率、感染前手术率及呼吸机辅助呼吸率高于对照组(Plt;005);以G感染胰腺、胰周围及肺部为主;肺部感染时间为107±25d,胰腺或胰周为176±29d。结论:急性期全身反应轻重及胰腺坏死程度是SAP继发感染的基础;临床有创治疗措施是促进因素。
Objective To summarize the change in the cytokine network, the classification of various cytokines, interaction, and systemic impact on patients with acute pancreatitis (AP). Methods The recently published literatures in domestic and abroad about advancement of cytokines in AP were reviewed. Results Cytokines had a complex network and interactions. There were a variety of regulatory mechanisms. The tumor necrosis factor-α (TNF-α) and interleukin cytokines played important roles in the progress of AP. Conclusions Change of cytokines during AP is a complex process. Any separate regulation for the release of sigle factor has no significant effect on the disease. The treatment according to immune balance should be a better direction.
Ａ ｒｅｖｉｅｗ ｏｆ ｐａｔｉｅｎｔｓ ｗｉｔｈ ａｃｕｔｅ ｐａｎｃｒｅａｔｉｔｉｓ ｔｒｅａｔｅｄ ｉｎ ｔｈｉｓ ｈｏｓｐｉｔａｌ ｉｎ ｒｅｃｅｎｔ １０ ｙｅａｒｓ ｗａｓ ｍａｄｅ．Ｔｏ ｄｅｔｅｒｍｉｎｅ ｔｈｅ ｒｉｓｋ ｆａｃｔｏｒｓ ｏｆ ｓｅｐｔｉｃ ｎｅｃｒｏｓｉｓ ｉｎ ａｎｄ ａｒｏｕｎｄ ｔｈｅ ｐａｎｃｒｅａｓ，３２ ｃａｓｅｓ ｗｉｔｈ ｓｅｐｔｉｃ ｎｅｃｒｏｓｉｓ ｗｈｉｃｈ ｗｅｒｅ ｐｒｏｖｅｄ ｉｎ ｓｕｒｇｉｃａｌ ｏｐｅｒａｔｉｏｎ ａｎｄ ４４ ｃａｓｅｓ ｗｉｔｈｏｕｔ ｓｅｐｔｉｃ ｎｅｃｒｏｓｉｓ（ａｓ ｃｏｎｔｒｏｌ）ｗｅｒｅ ｉｎｃｌｕｄｅｄ ｉｎ ｔｈｉｓ ｓｔｕｄｙ．Ｔｈｅ ｐｏｓｓｉｂｌｅ ｆａｃｔｏｒｓ ｗｅｒｅ ｃｏｍｐａｒａｔｉｖｅｌｙ ａｎａｌｙｓｅｄ．Ｔｈｅ ｒｅｓｕｌｔｓ ｓｈｏｗｅｄ ｔｈａｔ ｓｅｐｔｉｃ ｎｅｃｒｏｓｉｓ ｉｎ ａｎｄ ａｒｏｕｎｄ ｔｈｅ ｐａｎｃｒｅａｓ ｏｂｖｉｏｕｓｌｙ ｒｅｌａｔｅｄ ｔｏ ｔｈｅ ｄｉａｇｎｏｓｔｉｃ ｏｒ ｔｈｅｒａｐｅｕｔｉｃ ｐｕｎｃｔｕｒｅｓ，ｅａｒｌｙ ｓｕｒｇｉｃａｌ ｄｒａｉｎａｇｅ ａｎｄ ｐａｒａｌｙｔｉｃ ｉｌｅｕｓ（ＯＲ ３０２－５４８，Ｐ＜００５)，ｂｕｔ ｔｈｅｒｅ ｗｅｒｅ ｎｏ ａｓｓｏｃｉａｔｉｏｎｓ ｗｉｔｈ ａｇｅ，ｅｔｉｏｌｏｇｙ，ｓｈｏｃｋ，ｒｅｓｐｉｒａｔｏｒｙ ｆａｉｌｕｒｅ ａｎｄ ｔｏｔａｌ ｐａｒｅｎｔｅｒａｌ ｎｕｔｒｉｔｉｏｎ（ＯＲ ０７８－１２６，Ｐ＞００５）．Ｔｈｅ ａｕｔｈｅｒｓ ｓｕｇｇｅｓｔ ｔｈａｔ ｅｉｔｈｅｒ ｐａｎｃｒｅａｔｉｃ，ｐｅｒｉｐａｎｃｒｅａｔｉｃ ｐｕｎｃｔｕｒｅ ｏｒ ｅａｒｌｙ ｓｕｒｇｉｃａｌ ｄｒａｉｎａｇｅ ｓｈｏｕｌｄ ｂｅ ｌｉｍｉｔｅｄ ａｎｄ ａｎｙ ｍｅｄｉｃａｔｉｏｎ ｗｈｉｃｈ ｍａｋｅｓ ｐａｒａｌｙｔｉｃ ｉｌｅｕｓ ｄｅｔｅｒｉｏｒａｔｅｄ ｓｕｃｈ ａｓ ａｔｒｏｐｉｎｅ ｓｈｏｕｌｄ ｂｅ ａｖｏｉｄｅｄ ｉｎ ｔｈｅ ｔｒｅａｔｍｅｎｔ ｏｆ ａｃｕｔｅ ｐａｎｃｒｅａｔｉｔｉｓ．
The aim of this study was to investigate the role of tumor necrosis factor (TNF), interleukin-6(IL-6), C-reactive protein (CRP) in pancreatitis and its systemic complications. Thirty six patients with acute pancreatitis were studied, 12 with mild disease, and 24 severe disease, of whom 9 developed systemic complications. TNF, IL-6, CRP in these patients with pancreatitis was assessed during the first, 4th, 8th days of admission. The serum concentration of TNF, IL-6, CRP were significantly increased, and significantly higher in complicated group than in mild group and severe group. These findings suggest that proinflammatory cytokines play a central role in the pathophysiology of the disease, the host systemic response to pancreatic inflammation and the level of the response did relate to the development of organ dysfunction.