Treatment tactic of patients with acute pancreatitis depending on the endotoxicosis grade


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Abstract

Treatment results of 177 patients with acute pancreatitis were analysed according to endotoxicosis grade, blood serum amylase and myoglobin level on admission. Patients with I-grade endotoxicosis and moderate blood level of amylase and myoglobin underwent conservative treatment which resulted in early healing of the pancreatic inflammation. The operative activity of patients with II-grade of endotoxicosis made up 41,2 %. As a result of intensive therapy and laparoscopic abdominal lavage the pancreatic infiltrate became infected with significant rise of blood serum amylase and myoglobin level. There was no mortality in this group. Patients with III-grade endotoxicosis and very high level of blood serum myoglobin had disseminated chemical peritonitis with retroperitoneal abscesses and they had proper laparotomy. In this group there was a mortality of 54,5%. Therefore blood serum myoglobin has been shown to be a marker for tissue destruction.

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Ростовский государственный медицинский университет

Author for correspondence.
Email: v.chernov@mail.ru
доктор медицинских наук, профессор, вице-президент Ассоциации общих хирургов Российской Федерации, заведующий кафедрой общей хирургии Ростовского государственного медицинского университета, заслуженный деятель науки Российской Федерации.

Ростовский государственный медицинский университет

Email: baa_1981@mail.ru
врач-хирург хирургического отделения МУ «Каневская ЦРБ» Краснодарского края, соискатель кафедры общей хирургии Ростовского государственного медицинского университета.

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