IMPROVEMENT OF DIAGNOSTIC METHOD FOR MICROCIRCULATORY DISORDERS IN ACUTE PANCREATITIS

Abstract

Introduction. Acute pancreatitis (AP) is one of the most common diseases of the digestive system that requires hospitalization. It ranks the second position after acute appendicitis among acute diseases of the digestive system. The mortality rate from severe AP forms puts this disease in the first position in terms of lethality rates among acute surgical pathology of the abdominal cavity. At the initial stages of the disease, a cascade of immunological reactions occurs that leads to significant changes in rheology and function in the systemic microcirculatory bed in the first hours of the disease. This study aims to identify the optimal point of examination for assessing microcirculatory function in patients with AP and to improve the diagnostic and prognostic capabilities of laser Doppler flowmetry (LDF) in evaluating the AP severity.
 Materials and methods. The assessment of the microcirculatory state of patients by the LDF method was carried out using “LAKK-02” device. During the application of the LDF method, the primary studies were carried out at three points (proximal, central and distal) of the anterior surface of the right forearm. In order to study the effect of indicators on the degree of disease severity, paired correlation coefficients for each of them were calculated for the above-mentioned points.
 Results. All generalized microcirculation indicators (for M - 0.679, for o - 0.653, for Kv - 0.706), as well as respiratory, cardiac and neurogenic indicators in amplitude wavelets at the distal point, have the most significant and considerable impact compared to other points. On the other hand, frequency wavelet data have no significant correlation with the severity of AP in any of the examination points, which characterizes this wavelet as not significant in determining the degree of severity of AP in the 1-3 day examination.
 Conclusion. The findings of this study suggest that by focusing on specific examination points, it is possible to reduce overall exposure and obtain homogeneous data on essential indicators. This approach enables a more comprehensive and higher quality analysis of wavelet indicators, thus improving the diagnosis and prognosis of AP severity.