Analysis of the results of treatment of patients with destructive forms of acute pancreatitis
DOI:
https://doi.org/10.14739/2310-1210.2013.4.16915Keywords:
destructive forms of acute pancreatitis, intensive therapy, procalcitonin, hemodiafiltrationAbstract
In Ukraine the incidence of acute pancreatitis is 102 per 100 000 population. In recent years researches in the field of the methods of diagnostics of disease severity showed that one of the most promising is determination of the concentration of procalcitonin in blood. The experience of application hemodiafiltration was described In the literature.
The purpose of the research: to analyze the results of treatment of patients with destructive forms of acute pancreatitis with the use of modern methods of diagnostics and treatment.
Materials and methods. The study included 15 patients with destructive forms of acute pancreatitis. The severity of the patient's condition was evaluated by the scale APACHE II, the degree of multiple organ failure (MOF) by the scale SOFA, the degree of endogenous intoxication by assess of the leukocyte index of intoxication (LII) and concentration of procalcitonin.
Results. Only 11 patients recovered, five had purulent-septic complications, which in one case led to a lethal outcome. Three patients admitted in the extremely pore condition of the disease with lethal outcome in connection with the development of shock and multiple organ failure. The highest values of procalcitonin corresponded to the maximum values of APACHE II and SOFA. Three patients received prolonged venous-venous hemodiafiltration and in two of them positive dynamics was got: decreased number of points by APACHE II ≤6,SOFA≤3, decreased LII ≤7 and concentration of procalcitonin, one became death.
Conclusions. For the assessment of severity of disease it is necessary to determine the concentration of procalcitonin. In the complex intensive therapy the prolonged venous-venous hemodiafiltration use is justified.
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