11) An estimation of weight of sharp pancreatitis is after a scale Ranson.

For the estimation of weight of sharp pancreatitis the modified scale of Ranson is used .

During 24 hours 6 indexes are taken into account :

1. Age of patient is older than 55.

2. The expressed and resistance is to therapy of pain syndrome.

3. Heart rate > 120 kick for 1 minute.

4. Arterial pressure (systole)< 100 mm of mc. century

5. Level of Нв > 150 gs/л.

6. Content of glucose > 10 mmol/l.

During 48 hours taken into account :

7. Level of АST > 2 mmol/l.

8. Coefficient of АLТ/АSТ < 1.

9. Index of indirect bilirubin (at a hyperbilirubinemia)> 60 mkmmol/l.

10. Level of kreatinine > 110 mkmmol/l.

11. ра02 < 60 mm of mc. century

12. DB (deficit of bases)> 4 mmol/l.

13. Maintenance of tachycardia > 120 kick after 1 min

14. Maintenance of hypotension of BP (PROPULSION MODULE)< 100 mm of mc. century

12) Determination of index of Alhover is at the different degrees of blood loss.

A shock index of Alhover is a relation of heart rate to the level of systole arteriotony. At this index estimate the relative diminishing of blood volume.

An index of Alhover (heart rate / systolic blood pressure) is volume of blood loss, % blood volume

0,8 and less than 10

0,9-1,2 20

1,3-1,4 30

1,5 and anymore 40

about 0,6-0,5 normal blood volume

Note: heart rate is frequency of heart-throbs; systolic blood pressure is an arteriotony; blood volume is a volume of circulatory blood.

13) Establishment of bleeding source is by the nature of the vomitive and excrement masses.

By the nature of the vomitive masses it is possible to diagnose localization of bleeding source :

1. Vomit the unchanged blood testifies to the considerable bleeding in a stomach (ulcer, tumour, hemorragic gastritis, syndrome of Mallory-Weiss);

2. Vomit a liquid as "coffee-grounds" mostly meets at the ulcer of duodenum. The black of the vomitive masses is predefined by the presence of muriatic hematin - chemical product into that Hb grows under act of muriatic acid;

3. Vomit a "complete mouth" the clots of cherry blossom is characteristic for the varicose widespread veins of gullet or forestomach.

By the nature of the excrement masses it is possible to set intensity and approximate localization of bleeding source.

A black or tarry chair is the permanent clinical sign of bleeding from the overhead departments of gastrointestinal tract. The black of chair is predefined by disintegration of blood in bowel with formation of sulphuric iron. All patients with suspicion on the gastroenteric bleeding are subject to dactylar rectal research.

1. Well executed a black chair testifies to the moderate bleeding from a stomach or duodenum;

2. A tarry multiple chair testifies to the intensive bleeding of overhead departments of gastrointestinal tract;

3. A dark-cherry color of chair is a result of rapid advancement of blood on bowel (profuse massive bleeding) or bleeding from the bottom departments of bowel;

4. A presence in incandescence of "raspberry jelly" with mucus is a sign of ulcerous colitis.