ABSTRACT
Objective To discuss the value of combining the physiological and operative severity score for enumeration of mortality and morbidity(POSSUM)and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)in severe acute pancreatitis(sAP).Methods 60 cases of SAP were divided into surgery group(n=15)and non-surgical group(n=45),Non-surgical group was vahde with APACHE Ⅱ score,the surgery group with POSSUM score,decided to continue conservative treatment or surgery treatment,Observation of two ways with the complications and death.Results The rates of compHcafions and death were(0.37±0.08)and(0.27±0.09)in Single-operation group(n=15)higher than(0.76±0.14)and(0.61±0.15)in surgical group(n=11)(t1=3.125,t2=3.211,P＜0.01);APACHEⅡ score of mortality in operation group and non-surgical group were no significant difference(x2=2.28,x2=1.98,P＞0.05);APACHE Ⅱ score were(10.12±6.27)in survival group(n=46)were lower than (25.75±7.90)in death group(n=14)(t=2.525,P＜0.05.Conclusion The score of dynamic APACHE Ⅱ has better effect to judge the timing of surgery,and the score of POSSUM has high value to predict post-operative complications and deaths occurred in patients with severe acute pancreatitis.
ABSTRACT
Objective To study the clinical significance and changes of serum TNF-α、IL-6、IL-8、PAFand AGT-Ⅱ in patients with severe acute pancreatitis(SAP). Methods Serum TNF-α、IL-6、IL-8、PAF、AGT-Ⅱ values of all patients were measured by ELISA and radioimmunoassay. 30 cases with mild AP(MAP group),50 cases with SAP(SAP group) and 30 non-pancreatitis patients as control group. Results The level of TNF-α, IL-6, IL-8, PAF, AGT-Ⅱ of acute phase and recovery phase in SAP group and the MAP group were significantly higher than the normal control group(all P < 0.01); the level of TNF-α、IL-6、IL-8、PAF and AGT-Ⅱ of acute phase in SAP group were significantly higher than the MAP group(all P <0.05); the level of TNF-α、IL-6、IL-8、PAF and AGT-Ⅱ of re-covery phase in SAP group were significantly lower than the acute phase(all P <0.05);the level of TNF-α、IL-6、IL-8、PAF and AGT-Ⅱ of died in SAP group were significantly higher than the survivors (all P < 0.05～0.01). Conclu-sion The level of TNF-α、IL-6、IL-8 with the severity of SAP's condition and prognosis is closely related, The level of AGT-Ⅱ in SAP group were significantly higher than the MAP group.