重症急性膵炎におけるエンドトキシン吸着療法(<特集>肝・膵疾患とアフェレシス)

概要

論文の詳細を見る
The effectiveness of endotoxin elimination therapy(PMX therapy)for sepsis includ- ing severe acute pancreatitis was evaluated. Clinical signs such as blood pressure, cathecolamine requirement and body temperature of g patients with septic shock and/or severe sepsis were analyzed before and after PMX therapy. Of the g patients,5underwent complete removal of the infection focus before PMX therapy, and 4 did after PMX therapy. After PMX therapy, blood pressure was elevated and cathecolamine administration to 8 patients could be decreased, and 6 patients survived(survival rate:67%). In 2 patients with pancreatic infection, parameters such as blood pressure, body temperature and serum endotoxin level were improved after PMX therapy, and infected lesions were completely removed safely. Although drainage should be performed as soon as possible after infection in patients with severe pancreatitis, we often hesitate to do so because of the poor conditions in the acute period with multiple organ failure and/or septic shock status, or difficultly in diagnosing infection. In such situations, PMX therapy is quite a useful tool for secondary pancreatic infection as a bridge until the operation, or for perioperative endotox- emia.
日本アフェレシス学会の論文
1997-10-31