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Formalized therapeutic guideline for hyperlipidemic severe acute pancreatitis

World Journal of Gastroenterology 2003年第11期9卷 2622-2626页

作者： En-Qiang Mao Yao-Qing Tang Sheng-Dao Zhang, Department of Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China Department of Surgery Ruijin Hospital Shanghai Second Medical University Shanghai 200025 China. maoeq@***

AIM: To investigate a formalized therapeutic guideline for hyperlipidemic severe acute pancreatitis (HL-SAP).METHODS: Thirty-two consecutive patients with severe acute pancreatitis were included in the clinical trial. All of them met the following five criteria for admission to the study, namely the Atlanta classification and stratification system for the clinical diagnosis of SAP, APACHEII score more than 8, time interval for therapeutic intervention less than 72 hours after onset of the disease, serum triglyceride (TG) level 6.8 mmol/l or over, and exdusion of other *** were divided into severe acute pancreatitis group (SAP,22 patients) and fulminant severe acute pancreatitis group (FSAP, 10 patients). Besides the conventional therapeutic measures, Penta-association therapywas also applied in the two groups, which consisted of blood purification (adsorption of triglyceride and hemofiltration), antihyperlipidemic agents (fluvastatin or lipanthyl), low molecular weight heparin (fragmin), insulin, topical application of Pixiao (a traditional Chinese medicine) over the whole abdomen, serum triglyceride,pro-inflammatory cytokines and anti-inflammatory cytokines were determined before blood purification (PF), at the end of blood purification (AFE) and on the 7th day after onset of the disease (AF7) respectively. Simultaneously, severity of the diseases was assessed by the APACHE Ⅱ *** was evaluated by non-operation cure rate,absorption rate of pseudocyst, time interval pseudocyst absorption, hospital stay and survival ***: Serum triglyceride level (mmol/L), TNFα (U/mi) concentration and APACHE Ⅱ score were significantly decreased (P＜0.05) at AFE and AF7, as compared with ***, serum IL-10 concentration (pg/ml) was increased significantly (P＜0.001) at AFE, and decreased significantly (P＜0.05) at AF7 when compared with PF. Operations: The First surgical intervention time was 55.8±42.6 days in SAP group (5 patients) and 12.2±6.6 days

关键词：高脂血性重症急性胰腺炎治疗指南甘油三酸酯临床特点

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