- Viem tuy cap the chay mau Viem tuy cap the hoai t
8.2.1.Xet nghiem sinh hoa
8. TRIEU CHL/NG VA CHAN DOAN
8.2.1.Xet nghiem sinh hoa
- A m ylase mau: Khi tang cao tren 3 lan binh thiidng, ket hdp vdi cac trieu c h in g lam sang co the ch&n doan viem tuy cap.
Do nhay cua amylase mau trong chain doan viem tuy cap la 95% theo Sleisenger va Fontran, ti'nh dac hieu cua no la 85% theo Belghiti.J va Coll[19].
Tuy nhien amylase mau tang, khong phai chi dac hieu trong viem tuy cap, trong mot so benh khac cung gay amylase mau tang nhii: thung o loet da day - ta trang, ch ia ngoai til cung vd, nhoi mau mac treo ruot, viem tuyen niidc bot mang tai..., nhung thudng chi tang gap 2-3 lan tri so'binh thudng
Hoac ngiidc lai amylase mau khong tang cung khong phai la yeu to' de loai t r i viem tuy cap: nhii trUdng hdp viem tuy cap cf giai doan muon, da qua giai doan tang amylase hoac tuy bi hoai tii gan nhii toan bo. Nhii vay trong da so' cac trUdng hop viem tuy cap thi Amylase mau, Amylase nieu deu tang (chu yeu la tang gap 10 lan binh thiidng), nhiing neu gap triidng hdp Amylase mau, Amylase nieu thap, ngay ca khi dudi miic binh thudng thi chung ta van chUa the loai t r i hoan toan kha nang benh nhan bi viem tuy cap. Trong nhiing triidng hdp nhii vay, chung ta can lam them cac tham do ho trd chan doan khac, de xac dinh chan doan
- Lipase: Lipase mau tang > 3 l&n binh thiidng cd gia tri chan doan viem tuy cap hdn la tang amylase mau, ngoai ra do sii tang lipase mau keo dai hdn sii tang amylase mau, nen no se la mot xet nghiem de chan doan va theo doi viem tuv cap tot hdn, tuy nhien tang lipase mau cung khong chi dac hieu trong viem tuv cap, ma con tang trong cac benh ly khac nhii: thung o loet da day- ta trang, nhoi mau mac treo ruot, tac ruot, suy than
- Calci mau, magie mau: giam 59,9% cac triidng hdp la Canxi mau binh thiidng, difdi 2mmol/l cd 9,8%. (day la yeu to tien liidng trong 48h dau theo Ranson), ket qua nav tiiOng tii vdi nghien c iu cua N guyln Thi H&ng la 10%,
Cac triidng hdp viem tuy cap hoai t i , s i giam can xi mau la hau qua cua qua trinh can xi ket hdp vdi axit beo tii do diidc
giai phong trong qua trinh phan huy lipid de tao ra hinh anh vet nen.
- Ure mau: Nghien ciiu cua chung toi chu yeu cac triidng hdp la Ure mau d gidi han binh thudng (83,8%), chi cd 16,2% la tang ure mau, trong do tang tren 16mm/l cd 2,8% (yeu to tien liidng trong 48h dau theo Ranson), ure mau tang theo nghien ciiu cua Nguyen Thi Hang la 16%, Ton That Bach va cong sii la 29,4%.
- Dudng mau: - Diidng mau tang, chiem 53,6%.Ty le tang diidng mautang tren llm m ol/1 chi cd 3,8%. (yeu to" tien liidng gid 0 theo Ranson), cao hdn so vdi ty le tang dudng mau cua Nguyen Thi Hang 14%.
- Billirubin toan phan mau: - Bilirubine tang trong trUdng cd tac mat theo ket qua nghien ciiu cua chung toi thi so" triidng hdp cd Billirubin toan phan tang tren 20mmol/l la 81,3%.Day la dau hieu gian tiep chi diem cd sii can trd liiu thong d diidng mat