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題名 | 術後澱粉酶肌酸酑廓清率比測定之意義 |
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作者 | 李金德; 柯成國; 沈柏青; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 19:5 1986.11[民75.11] |
頁次 | 頁398-403 |
分類號 | 416.247 |
關鍵詞 | 術後; 澱粉酶肌酸酑廓清率比; |
語文 | 中文(Chinese) |
中文摘要 | 高雄醫學院肝胆外科以35位膽道進外科手術及17位整形外科手術病例,測定術後澱粉酶肌酸酑廓清率比,以暸解兩群病患其術後胰炎發生的情況及可能代表的意義。胆道外科手術群其術前ACCR干均值(M±SD)為2.29±0.89%,術後第一日為3.75±2.77% (P<0.01),第二日為3.24±2.16% (P<0.05),第三日2.69±1.7%,第七日2.67±1.29% (P>0.05)。術後異常高ACCR值(>5.3%)的有13例佔37.1%;其中所有病例其血清澱粉酶都在正常值內,8例(61.5%)的尿中澱粉酶高於正常值,9例(69.2%)尿中肌酸酑低於正常值,因此我們認為胆道外科手術群術後ACCR之上升與手術操作之侵犯胰臟組織有關。 整形外科手術群其街前ACCR平均值(M±SD)為1.85±0.92%,術後第一日為2.57±1.51%,第二日2.03±0.96%,第三日2.55±1.76%,第7日1.90±1.04%(P>0.05),共有2例(11.8%)其ACCR異常升高;但其血清及尿中澱粉酶都在正常值,而尿中肌酸酑却都低於正常值,因此我們認為其ACCR之上升與胰臟本身無闕,而係腎臟因素所致。 兩群之術前及街後各日之ACCR值,異常ACCR值之發生率,都沒有顯著性差異(P>0.05)。 |
英文摘要 | Amylase creatinine clearance ratios (ACCR) were checked before and after operation in 35 cases of hepatobiliary surgery and 17 cases of plastic surgery in order to determine the ACCR after the different operations and to examine its diagnostic value in recognizing postoperative pancreatitis. The ACCR checked before operation was 2.29±0.89% (M±SD) in biliary surgery; the first postoperative day it was 3.75±2.77% (p<0.01); the second day, 3.24±2.16% (p<0.05); the third day, 2.67±1.7%; the 7th day, 2.67±1.29(p>0.05). Thirteen cases (37.1%) had abnormally high ACCR; all the cases had normal serum amylase; eight cases (61.5%) were found to have abnormally high urine amylase and nine cases (69.2%) had abnormal low urine creatinine. The conclusion was that a high ACCR in biliary surgery may be caused by injury to the pancreas during operation. The preoperatíve ACCR was 1.85±0.92% (M±SD) in plastic surgery; the first postoperative day it was 2.57±1.51%; the second day, 2.03±0.96%; the third day, 2.55±1.76% and the seventh day 1.90±1.04% (p>0.05). Two cases (11:5%) were found to have abnormally high ACCR. All the cases had normal serum and urine amylase but, in contrast, two cases had abnormally low urine creatinine. The abnormally high ACCR in plastic surgery may be reflect renal function and not be a reflection of pancreatic injury. There was no significance (p>0.05) between the two groups in comparison of ACCR and incidence of cases of abnormally high ACCR. |
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