日本消化器外科学会雑誌第41巻第1号
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3 Table Profilesofthepatientswithsevereacutepancreatitis Gender(male:female) Age(years) Etiology Alcohol Cholelithiasis Hyperlipidemia Idiopathic Post-ERCP MHLW severityscore(stage) stage stage stage4 SOFA score(mean±sd) APACHE Iscore(mean±SD) Primaryinfectionrates(%) AOSC pneumonia MPgroups(n= 6) 8:8 55( 79) ±4..±7..5 IPgroups(n= 4) :4 54(4 7) ±.4.±5. 7. MHLW severityscore:ministryofhealth,labourandwelfareseverityscore SOFA score:sequentialorganfailureassessmentscore APACHE Iscore:acute physiologyandchronichealthevaluationscore AOSC:acuteobstructivesuppurativecholangitis Table Evaluationofsevereacutepancreatitisby contrastenhancedcomputedtomography Extentofpancreaticnecrosis None <% ~ 5% >5% MP groups 8 IP groups 7 Extentofextrapancreaticinflam mation MP groups 6 IP groups 4 χ
4 Table StartdayanddurationoftheCRAIandthelocationofthetip ofcatheter Periodsfrom theonsettoastart(days) MPgroups:( ) IPgroups:( ) Period(days) MPgroups:7(5 7) IPgroups:6(5 7) Locationoftipofcatheter Gastroduodenalartery Commonhepaticartery Splenicartery Superiormesentericartery MPgroups(n= 6) IPgroups(n= 4) 6 4 CRAI:continuousregionalarterialinfusion Table4 Theenforcementratesand thestarting daysanddurationdaysofchdf,sdd + EN CHDF Enforcementrates(%) Start(days) Period(days) SDD + EN MPgroups 7.5(n= 6) ( ) (7 4) MPgroups Enforcementrates(%) 6.5(n= ) Start(days) 5( ) IPgroups 4.9(n= 6) ( 6) 8( 4) IPgroups 57.(n= 8) 4( 7) CHDF:continuoushemodiafiltration SDD + EN:selec tivedecontaminationofthedigestivetract+enteralnutri tion
5 Fig. A:TransitionsintheMHLW severityscores foracutepancreatitisduringintensivecareinthe MPandIPgroups.MHLW severityscore:minis tryofhealth,labourandwelfareseverityscore B:TransitionsintheAPACHE Iscoresforacute pancreatitisduringintensivecareinthempand IP groups.apache Iscore:acutephysiology andchronichealthevaluationscore C:Transitions inthesofa scoresforacutepancreatitisduring intensivecareinthemp andip groups.sofa score:sequentialorganfailureassessmentscore. Methicillin-resistannt staphylococcus
6 aureusmrsa Enteroccocus facium Pseudomonas aeruginosa Enteroccocus faecalis Clostridium difficile Fig. ChangesintheCRPlevelsduringintensive careinthempandipgroups.crp:c reactive protein. Table5 Theincidenceofthecomplicationandsurgicaltreatmentrates,themortalityintheMPand IPgroups Table6 InfectionsiteintheMPandIPgroups MPgroups IPgroups (n= 6) (n= 4) p-value Infection Pancreatitis-related complication Infected pancreatic necrosis Surgicaltreatment Mortality MPgroups (n= 6) 6(7.5%) (.5%) ( 6.%) ( 6.%) ( 6.%) IPgroups (n= 4) 6(4.9%) (.4%) ( 7.%) (4.%) ( %) p-value Expectoration Catheter Blood Feces(Pseudomembranousenteritis) Pancreaticnecrosis Retroperitoneum Surgicalincision Urinarytract 5 Table7 CausativepathogensisolatedintheMPandIPgroups MPgroups(n= 6) IPgroups(n= 4) p-value Methicilin-resistantstaphylococcusaureus Enterococcusfaecium Pseudomonasaeruginosa Enterococcusfaecalis Clostridium dificile Enterobactoraerogenes Escherichiacoli Bacteroidesfragilis Bacilusspecies Proteusmirabilis 4
7 MRSA Enteroccocus facium Pseudomonas aeruginosa Enteroccocus faecalis Clostridium difficile
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9 Pseudomonas aeruginosa
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