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.
bjectiveTo observe the effecacy of immunosuppressive agents on modulation of the disorders of inflammatory and antiinflammatory cytokines in acute pancreatitis, and to investigate the mechanism of treatment of acute pancreatitis with immunosuppressive agents. MethodsSD male rats were divided into 6 groups: group 1, the normal control group (n=6); group 2, acute pancreatitis induced by ductual injection of 5%sodium cholate sulfur at the volume of 1.0 ml/kg without treatment (n=8). After the pancreatitis were induced, the rest rats were injected intravenously with 5Fu 40 mg/kg (group 3, n=6); or methylprednisolone 30 mg/kg (group 4, n=6); or cyclophosphamide 20 mg/kg (group 5, n=6); or methotrexate 1.2 mg/kg (group 6, n=6). Twentyfour hours afteroperation, the animals were killed, the blood samples were taken for measurement of TNFα, IL1, IL6 (by bioassay), and IL10, TGFβ (by ELISA) as well as amylase. ResultsThe inflammatory cytokines (TNFα,IL1,IL6 ) and the antiinflammatory cytokines (IL10 and TGFβ), in blood of acute pancreatitis were increased significantly. After treated with immunosuppressive agents, both the inflammatory and antiinflammatory cytokines were decreased in different degrees. Some indexes of the severity of acute pancreatitis, such as amylase and pancreatic weight were improved obviously.ConclusionImmunosuppressive agents can regulate inflammatoryassociated cytokines increased remarkably in the acute pancreatitis. Therefore, improvement of acute pancreatitis can be achieved through rectifying the abnormal immunity and relieving the pathophysiological disorders of the acute pancreatitis by immunosuppressive agents.
摘要:目的:動態監測急性胰腺炎(AP)患者外周血C反應蛋白(CRP)水平,探討CRP對AP的早期診斷與病情評估的參考價值。方法:分別檢測75例SAP患者和75例 MAP患者入院后第1、3、5、7、9天外周血CRP水平,并進行分析比較。結果: MAP組患者CRP高峰值出現在住院第3天,第7天開始下降,14天后恢復正常。而SAP組患者住院第1天即可出現CRP顯著增高,且下降速度緩慢,在后期CRP仍可維持在一個較高水平。入院第1天,SAP組血清CRP水平均顯著高于MAP組(Plt;0.01)。輕癥與重癥組(無并發癥或有并發癥)之間患者血清CRP水平差異均有高度顯著性(Plt;0.01)。結論: 動態監測CRP可作為AP早期診斷、疾病嚴重程度評估及預后判斷的一個獨立的衡量指標,值得臨床推廣應用。Abstract: Objective: To dynamic monitoring of acute pancreatitis (AP) in patients with Creactive protein (CRP) levels, CRP on the AP to explore the early diagnosis and prognostic evaluation of the reference value. Methods: 75 cases of SAP patients were examined and 75 patients with mild acute pancreatitis (MAP) after admission in patients with CRP levels in peripheral blood 1,3,5,7,9 days, and conduct analysis and comparison of. Results:MAP peak value of CRP in patients in hospital the first 3 days, 7 day drop in 14 days after return to normal. The SAP Group 1st day of hospitalization was significantly higher CRP can occur, and the rate of decline is slow, in the latter part of CRP can be maintained at a high level. Admission day 1, SAP serum levels of CRP were significantly higher than the MAP group (Plt;0.01). Between mild and severe group, no complications and complications in patients with serum CRP levels of SAP differences were highly significant (Plt;0.01). Conclusion:Dynamic monitoring of CRP can be used as AP early diagnosis, disease severity assessment and prognosis of an independent measure worthy of clinical application.
