Objective To investigate the changes of perioperative serum levels of interleukin-6(IL-6), C-reactive protein (CRP), and cortisol, as well as gastric intramucosal pH (pHi) and plasma lactate, aiming to compare systemi...Objective To investigate the changes of perioperative serum levels of interleukin-6(IL-6), C-reactive protein (CRP), and cortisol, as well as gastric intramucosal pH (pHi) and plasma lactate, aiming to compare systemic changes and tissue perfusion during colorectal and orthopaedic surgical procedures. Methods Twenty patients were randomly assigned to two groups, 10 cases of operation on vertebral canal, 10 cases of colorectal radical operation.Venous blood was drawn at 1 day before operation, 2, 4, and 6 hours following skin incision, and 1 day after operation, in order to measure serum IL-6, CRP, and cortisol.pHi and plasma lactate were also measured at the same time points.Results Serum concentrations of IL-6 and cortisol increased gradually following operation, reaching the peak value at 6 hours from the beginning of operation.CRP was not detectable until the first day after operation.Peak concentration of IL-6 had positive relationship with CRP.These variables changed more significantly in colorectal group than that in orthopaedic group (P<0.05).pHi decreased gradually, reaching the lowest level at 4 hours from the beginning of operation, and to more extent in colorectal group than that in orthopaedic group (P<0.05).Conclusion IL-6 may reflect tissue damage more sensitively than CRP.Colorectal surgery might induce systemic disorder to more extent, in terms of immuno-endocrinal aspect as well as tissue perfusion, reflected with pHi.展开更多
AIM： To evaluate whether multiple determinations of intramucosal pH （pHi） in acute pancreatitis （AP） patients could provide additional information of the disease severity during early hospitalization. METHODS： T...AIM： To evaluate whether multiple determinations of intramucosal pH （pHi） in acute pancreatitis （AP） patients could provide additional information of the disease severity during early hospitalization. METHODS： Twenty-one patients suffering from acute pancreatitis were monitored by gastric tonometry in the first 72 h after hospital admission. RESULTS： In the survivor group （n = 15） the initially low phi values returned to normal level （pHi ≥ 7.32） within 48 h （median pHi： d 1： 7.21; d 2： 7.32; d 3： 7.33）. In contrast, pHi values in the non-survivor group n = 6） were persistently either below or in the low normal range （median pHi 7.12; 7.12; 7.07 respectively）, but pHi differences between the two groups reached significance only after 24 h （P 〈 0.01）. Mucosal acidosis detected at any time during the monitored period was associated with the emergence of single or multiple organ dysfunction （P 〈 0.01）. CONCLUSION： Prolonged gastric mucosal acidosis was associated with remote organ dysfunction and failure in Acute Pancreatitis, however, correlation with the fatal outcome became significant only 24 h after admission. Due to its non-invasive nature gastric tonometry may supplement the pro-inflammatory markers to achieve a multi-faceted monitoring of the disease.展开更多
文摘Objective To investigate the changes of perioperative serum levels of interleukin-6(IL-6), C-reactive protein (CRP), and cortisol, as well as gastric intramucosal pH (pHi) and plasma lactate, aiming to compare systemic changes and tissue perfusion during colorectal and orthopaedic surgical procedures. Methods Twenty patients were randomly assigned to two groups, 10 cases of operation on vertebral canal, 10 cases of colorectal radical operation.Venous blood was drawn at 1 day before operation, 2, 4, and 6 hours following skin incision, and 1 day after operation, in order to measure serum IL-6, CRP, and cortisol.pHi and plasma lactate were also measured at the same time points.Results Serum concentrations of IL-6 and cortisol increased gradually following operation, reaching the peak value at 6 hours from the beginning of operation.CRP was not detectable until the first day after operation.Peak concentration of IL-6 had positive relationship with CRP.These variables changed more significantly in colorectal group than that in orthopaedic group (P<0.05).pHi decreased gradually, reaching the lowest level at 4 hours from the beginning of operation, and to more extent in colorectal group than that in orthopaedic group (P<0.05).Conclusion IL-6 may reflect tissue damage more sensitively than CRP.Colorectal surgery might induce systemic disorder to more extent, in terms of immuno-endocrinal aspect as well as tissue perfusion, reflected with pHi.
基金Supported by the Hungarian National Scientific Research Fund (OTKA), No. T 016630, and the Hungarian Ministry of Health(ETT), No. 276/2001
文摘AIM： To evaluate whether multiple determinations of intramucosal pH （pHi） in acute pancreatitis （AP） patients could provide additional information of the disease severity during early hospitalization. METHODS： Twenty-one patients suffering from acute pancreatitis were monitored by gastric tonometry in the first 72 h after hospital admission. RESULTS： In the survivor group （n = 15） the initially low phi values returned to normal level （pHi ≥ 7.32） within 48 h （median pHi： d 1： 7.21; d 2： 7.32; d 3： 7.33）. In contrast, pHi values in the non-survivor group n = 6） were persistently either below or in the low normal range （median pHi 7.12; 7.12; 7.07 respectively）, but pHi differences between the two groups reached significance only after 24 h （P 〈 0.01）. Mucosal acidosis detected at any time during the monitored period was associated with the emergence of single or multiple organ dysfunction （P 〈 0.01）. CONCLUSION： Prolonged gastric mucosal acidosis was associated with remote organ dysfunction and failure in Acute Pancreatitis, however, correlation with the fatal outcome became significant only 24 h after admission. Due to its non-invasive nature gastric tonometry may supplement the pro-inflammatory markers to achieve a multi-faceted monitoring of the disease.
