30 下列那一項不是評估非膽石性急性胰臟炎（non-gallstone pancreatitis）預後的Ranson’s criteria？

年齡＞55歲WBC＞16000/mm3

 Glucose＞200 mg/dL Amylase＞300 IU/L

AS: D

SURPRISINGLY NO AMYLASE!

Parameters used:

At admission:

1. age in years > 55 years
2. white blood cell count > 16000 cells/mm³
3. blood glucose > 10 mmol/L (> 200 mg/dL)
4. serum AST > 250 IU/L
5. serum LDH > 350 IU/L

At 48 hours:

1. Calcium (serum calcium <>
2. Hematocrit fall > 10%
3. Oxygen (hypoxemia P_O2 <>
4. BUN increased by 1.8 or more mmol/L (5 or more mg/dL) after IV fluid hydration
5. Base deficit (negative base excess) > 4 mEq/L
6. Sequestration of fluids > 6 L

The criteria for point assignment is that a certain breakpoint be met at anytime during that 48 hour period, so that in some situations it can be calculated shortly after admission. It is applicable to both gallstoneand alcoholic pancreatitis.

Alternatively, pancreatitis severity can be assessed by any of the following:^[2]

• APACHE II score ≥ 8
• Organ failure
• Substantial pancreatic necrosis (at least 30% glandular necrosis according to contrast-enhanced CT)

[edit]Interpretation

• If the score ≥ 3, severe pancreatitis likely.
• If the score <>

Or

• Score 0 to 2 : 2% mortality
• Score 3 to 4 : 15% mortality
• Score 5 to 6 : 40% mortality
• Score 7 to 8 : 100% mortality

[edit]Mnemonics for memorizing Ranson's criteria

• At admission: "GA LAW" (glucose, age, LDH, AST, WBC count)
• At 48 hours: "C HOBBS" (as in Calvin and Hobbes): (calcium, hematocrit, O₂, BUN, Base deficit, sequestration (of fluid) greater than 6 L (see: fluid balance)

or

• At admission: "Abe Was Laughing At George" (Age, WBC count, LDH, AST, Glucose)
• First 48 hrs: "His Brown Cat Bit Abe's Face" (Hematocrit, BUN, Calcium, BUN, Arterial O₂, Fluid sequestration (see: fluid balance))