THE FORECAST OF DEVELOPMENT OF PURULENT- DESTRUCTIVE COMPLICATIONS IN THE II PHASE OF SEVERE ACUTE PANCREATITIS

It is purulent -destructive complications of varying severity accompany from 30 to 80% of cases of severe acute pancreatitis (SAP). Lethality at SAP remains stable for several years and reaches 17-42% and at accession is purulent - destructive complications increases till 46-80%. It causes high interest in searching of the factors affecting on the course of pathological process and development of diagnostic and prognostic schemes. Research objective was development of a way of prediction of development is purulent - destructive complications of the II phase of the severe acute pan- creatitis (SAP) and assessment of diagnostic value of the offered way. Materials and methods: The basis of development of the offered way was formed by results of a research of 248 patients with severe acute pancreatitis, at 51 patients development was observed it is purulent - destructive complications in the II phase SAP.Carried out a computer angiography with bolus contrasting on the third week of a disease (14-21 days). Blood sampling for the developed analysis, defini- tions of integral hematological indexes and a blebbing of lymphocytes carried out also on the third week.On the basis of the obtained data the way of prediction of development was developed it is purulent - destructive complications in the II phase SAP. For approbation of the offered way the group of clinical observation of 72 patients SAP was created. Results: On the current of the II phase of severe acute pancreatitis the set of factors, including a condition of nonspecific immunity leukocytosis level, expressiveness of a lymphopenia, integral hematological indexes, activity of a blebbing of lymphocytes, damages of a pancreas and retroperitoneal space affects: visualization according to the KT-angiography of the devitalized tissues of a pancreas and a retroperitoneal fat, abundance of an inflammatory in- filtrate, and existence of vials of gas in a projection of liquid educations. Sensitivity of a way - 93,75%, specificity - 98,21%, accuracy - 97,22%, a prognostic significance of a positive take - 93,75%, a prognostic significance of the negative result - 98,21%. Conclusion: Prediction is purulent - the destructive processes is difficult a task.

pancreatitis, complications, prediction, severe current

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