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Прогностические критерии развития отдаленных осложнений острого панкреатита

Прогностические критерии развития отдаленных осложнений острого панкреатита

Abstract

An open controlled prospective randomized study has been cobducted. To achieve this goal there have been carried out a comprehensive examination, treatment and follow-up for 5 years of 119 patients who were underwent the first attack of acute pancreatitis. Checkpoints of the study were selected the day of admission to the hospital, 24 hours from the beginning of the intensive therapy, as well as the 3rd and 5th days. Repeatedly the full scope of diagnostic procedures was performed after 6 months from the date of admission. Monitoring of patients' state was carried out every month. Depending on the further evolution of acute pancreatitis, patients were divided into 4 groups. Group I included 27 patients, in whom acute pancreatitis with severe degree in the course of surveillance has evolved with the development of pancreatic pseudocysts. Group II (n = 43) included patients with chronic pancreatitis, group IV (n = 5) with pancreatogenic diabetes, in group III (n = 8) for the subsequent five years were no observed any pathological processes associated with structurally pancreas-functional changes. In the course of the study there was proved the role of autoimmune mechanisms and the effect of localization of the foci of pancreas in the development of pancreatogenic diabetes, area of inflammation in the development of postnecrotic pseudocysts of the pancreas, as well as the importance of fidelity to medical prescriptions in the likelihood of development of chronic pancreatitis on the background of endured extensive pancreatic lesions.

Проведено открытое контролируемое проспективное рандомизированное исследование. Для достижения поставленной цели проведено комплексное обследование, лечение и наблюдение в течение 5 лет за 119 больными, перенесшими впервые приступ острого панкреатита. Контрольными точками исследования были выбраны день поступления больного в стационар, 24 часа от начала интенсивной терапии, а также 3-и и 5-е сутки. Повторно полный объем диагностических манипуляций проводился через 6 месяцев со дня госпитализации. Контроль состояния больных осуществляли каждый месяц. В зависимости от дальнейшей эволюции острого панкреатита больные были разделены на 4 группы. Группа I была представлена 27 больными, острый панкреатит тяжелой степени у которых в ходе наблюдения эволюционировал с развитием псевдокист поджелудочной железы. В группу II (n=43) были включены больные с хроническим панкреатитом, в группу IV (n=5) с панкреатогенным сахарным диабетом, в группе III (n=8) в течение последующих 5 лет не наблюдалось патологических процессов, связанных со структурно-функциональными изменениями поджелудочной железы. В ходе проведенного исследования доказана роль аутоиммунных механизмов и влияние локализации патологического очага поджелудочной железы в развитии панкреатогенного сахарного диабета, площади воспалительного процесса в развитии постнекротических псевдокист поджелудочной железы, а также значимости приверженности врачебным назначениям в вероятности развития хронического панкреатита на фоне перенесенных обширных поражений поджелудочной железы.

Keywords

ОСТРЫЙ ПАНКРЕАТИТ,ХРОНИЧЕСКИЙ ПАНКРЕАТИТ,ПОСТНЕКРОТИЧЕСКИЕ КИСТЫ ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫ,ПАНКРЕАТОГЕННЫЙ САХАРНЫЙ ДИАБЕТ,ACUTE PANCREATITIS,CHRONIC PANCREATITIS,POSTNECROTIC PANCREATIC CYSTS,PANCREATOGENIC DIABETES

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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