Sunkaus ūminio pankreatito gydymas Klaipėdos universitetinėje ligoninėje

Abstract

Sunkus ûminis pankreatitas - tai liga, kurios metu sutrinka paèios kasos ir kitø organø funkcijos. Neþiûrint, kad ûminis pankreatitas pagal daþnumà uþima treèià vietà po apendicito ir cholecistito tarp ûminiø pilvo organø ligø, gerai þinomi ligos tyrimo ir gydymo algoritmai, sunkaus ûminio pankreatito eigos prognozavimas ir gydymas dar kelia daug sunkumø, o mirðtamumas iðlieka pakankamai didelis [1]. Ðio straipsnio tikslas - panagrinëti Klaipëdos universitetinëje ligoninëje dël sunkaus ûminio pankreatito gydytø ligoniø duomenis ir palyginti su literatûros duomenimis. Retrospektyviuoju metodu iðnagrinëtos 363 ligoniø, 2005- 2009 metais gydytø Klaipëdos universitetinëje ligoninëje dël ûminio pankreatito, ligos istorijos. Sunkus ûminis pankreatitas nustatytas remiantis klinikiniais poþymiais, biocheminiø kraujo tyrimø, pilvo ertmës organø ultragarsinio tyrimo ir kompiuterinës tomografijos (KT) su intraveniniu kontrastavimu duomenimis. Dalis ligoniø, iðsivysèius infekuotai kasos nekrozei, kasos abscesui ir vystantis sepsinëms komplikacijoms, operuoti. Pagrindinë ûminio pankreatito prieþastis- alkoholis. Dviem treèdaliams pacientø nustatytas lengvas, vienam treèdaliui - sunkus ûminis pankreatitas. Pusei pacientø, sirgusiø nekroziniu pankreatitu, kasos nekrozë nesiekë 30 proc. Iðoperuota treèdalis sunkiu ûminiu pankreatitu sirgusiø ligoniø. Mirë 29 sunkiu ûminiu pankreatitu sirgæ ligoniai. Sunkiu ûminiu pankreatitu serganèiø ligoniø gydymas Klaipëdos universitetinëje ligoninëje atitinka bendrus sunkaus ûminio pankreatito gydymo standartus. Gauti rezultatai atitinka sunkiu. [...]. Background. Severe acute pancreatitis is a disease that causes malfunction of the pancreas and other organ functions. Acute pancreatitis according to occupy takes third place after appendicitis and acute cholecystitis between acute abdominal diseases. It is well-known disease testing and treatment algorithms, but conduction of severe acute pancreatitis in the prediction and treatment still poses many challenges, and the mortality remains high enough. Thus, the goal of the present article is to explore the patients treated for severe acute pancreatitis in Klaipëda University Hospital and to compare it with the data presented in the literature. Patients and methods. The medical documentation of 363 patients who underwent treatment for acute pancreatitis in Klaipëda University hospital within the years 2005-2009 have been investigated by the retrospective method. Severe acute pancreatitis was diagnosed referring to the clinical data, biochemical blood tests, abdominal ultrasound and computed tomography (CT) examination with intravenous contrast data. Patients who develop infected pancreatic necrosis, pancreatic abscess and the development of septic complications were operated on. Results. Alcohol is the main cause of acute pancreatitis. The mild pancreatitis was diagnosed for two-thirds of patients and severe acute pancreatitis was diagnosed for one-third of patients. Half of patients with necrotic pancreatitis pancreatic necrosis did not exceed 30%. One- third of patients with severe acute pancreatitis were operated on. 29 patients with severe acute pancreatitis died. Conclusion. The treatment of patients with severe acute pancreatitis in Klaipëda University hospital is the same as standarts of the general treatment of severe acute pancreatitis. These results are consist