AKUT PANKREATÝT PROGNOZUNU BELÝRLEMEDE RANSON KRÝTERLERÝNÝN ETKÝNLÝÐÝ

1995-1999 yýllarý arasýnda hastanemiz 2. Genel Cerrahi Kliniðine akut pankreatit tanýsý ile 27 hasta yatýrýldý. Etyoloji, taný ve tedavi yöntemleri, morbidite, mortalite ve Ranson kriterlerinin prognoza etkisi retrospektif olarak incelendi. Hastalarýmýzda en sýk akut pankreatit nedeni biliyer sistem patolojileri idi (%55.6). 21 hastada medikal, 6 hastada cerrahi tedavi uygulandý. 2 hastada (n= 1 nekrozektomi + drenaj, n = 1 medikal tedavi) pankreas psödokisti (%7.4) geliþti. Mortalite oraný %18.5 (n=3 medikal tedavi,n=1 kolesistektomi+T tüp drenaj, n=1 drenaj) idi. Ex. olan hastalarýn yaþ ortalamasý 74.2 iken taburcu edilen hastalarýn yaþ ortalamasý 43 idi (p<0.001). Ranson skoru ex. olan hasta grubunda ortalama 5.4 iken, taburcu edilen hasta grubunda 2.3 idi (p<0.001). Ex. olan hasta grubunda ortalama kalsiyum deðeri 6.76 mg./dl, laktik dehidrogenaz deðeri 1660 IU/L iken taburcu edilen hastalarda bu deðerler sýrasýyla 8.59mg/dl ve 470 IU/L bulundu (p<0.001). Çalýþmamýzda Ranson kriterlerinin akut pankreatitin prognozunu belirlemede güvenilir olduðu görülmüþtür. Özellikle yaþ, kalsiyum, laktik dehidrogenaz ve BUN deðerlerinin prognozu etkileyen önemli kriterler olduðu saptanmýþtýr.

USEFULNESS OF RANSON CRITERIA FOR DETERMINATION OF PROGNOSIS IN ACUTE PANCREATITIS

Between 1995 and 1999, 27 patients with diagnosis of acute pancreatitis were admitted to 2nd surgical department of our hospital. Aetiology, diagnosis and treatment methods, morbidity, mortality and effect of Ranson criteria to prognosis were examined retrospectively. The most common aetiology in our patients was biliary system pathologies(55.6%). Twenty-one patients treated medically and 6 patients surgically. Pancreatic pseudocyst developed in 2 patients (n=1 necrosectomy+drainage, n=1 medical treatment). Mortality ratio was 18.5% (n=3 medical treatment, n= 1 cholecystectomy + T-tube drainage, n= 1 drainage). While the mean age was 74.2 in the patients died, it was 43 in the patients survived(p<0.001). Significant difference was found with regard to the mean Ranson score between the two groups (5.4 and 2.3, respectively) (p<0.001). Also, there was a significant difference with regard to the mean calcium and lactic dehydrogenase values between the died patients (6.76mg/dl and 1660 IU/L, respectively) and the survived patients (8.59mg/dl and 470 IU/L, respectively) (p < 0.001). In our study, Ranson criteria are found to be reliable to determine the prognosis of acute pancreatitis. Especially age, calcium, lactic dehydrogenase and BUN values are found to be important parameters effecting prognosis.