重症急性膵炎と腹膜灌流(<特集>肝・膵疾患とアフェレシス)

概要

論文の詳細を見る
Interest in the possibility that peritoneal lavage(PL)might benefit patients with severe acute pancreatitis was initiated by Wall in 1965. Its efficacy has usually been attributed to the removal of toxic substances that may be released by the pancreas including trypsin, phos- pholipase, prostaglandin, histamine, bradykinin, and some chemical mediators. But the role of PL remains debatable, and there are several problems involved with multicenter studies because of variations in cause, treatment protocol and therapeutic methods that may lead to different results. Seventeen patients with severe acute pancreatitis managed by PL at our institution were analyzed. The mortality rate was 17.6%, and almost all deaths of the lavaged patients were due to late pancreatic sepsis. It is our conclusion that PL is a valuable adjunct to the management of early complications of severe acute pancreatitis but does not influence the occurrence of the sequelae of pancreatic sepsis. In addition to PL, plasmapheresis and hemodiafiltration are available blood purification therapies for severe acute pancreatitis, and it is important that these therapies should be combined according to the condition.
日本アフェレシス学会の論文
1997-10-31