Clinical Analysis Of Severe Acute Pancreatitis: A Report Of 40 Cases

Objective:Explore to severe acute pancreatitis in the clinical character;investigate the relationship between the laboratory examination,imageology and clinical diagnosis by observing the result of them;evaluate the therapeutic effect of medical conservation and surgical operation.Methods:Review of the etiopathogenisis,clinical manifestation,auxiliary examination,complications and management of 40 patients with severe acute pancreatitis from the Second Affiliated Hospital,Medical College of Zhe Jiang University collected from Jan,2007 to Dec,2007.Results:In 40 patients,17 cases(42.5%)were males and 23 cases(57.5%)were females,sex-ratio is 1:1.35,SAP frequently.happen in people aged from 30-70 years old,the mean age was 49.2years.The etiopathogenisis of SAP are biliary tract stones(37.5%,15/40),hyperlipidemia(17.5%,7/40),alcohol(12.5%,5/40),post-ERCP(2.5%,1/40)and idiopathic(32.5,13/40).Abdominal pain(92.5%,37/40), nausea(70%,28/40),vomiting(70%,28/40),abdominal distension(52.5%,21/40) febrility(22.5%,9/40)were the most common symptoms,and the abdominal tenderness(100%,40/40),Hypoactive bowel sounds(30%,12/40)were the most commn physical examinations.The levels of serum Amylases,WBC,CRP,TG were high and serum calcium was low,the average level were 634.4 U/L,15.3 x10~9/L,141.8 mg/dl,194.4 mg/dl,7.9 mg/dl respectively.All 40 patients who received the scan of CT presented a positive finding.Among which 21 cases(52.5%)and 19 cases(47.5%)were grade D and grade E by Balthazar CT-class.The positive rate of SAP's diagnosis with CT is obviously higher than B-ultrasound(P＜0.01).97.5%of 40 patients with SAP were recovered by medical,and only 2.5%by surgical operation, no body died.The damage of hepatic function(20%,8/40),pseudocyst(15%,6/40) and pancreatic necrosis(12.5%,5/40)were the most commn complications.Conclusion:Severe acute pancreatitis most happen in people aged from 30～70 years old.Biliary tract stones,hyperlipidemia,alcohol was the most commn etiopathogenisis.Abdominal pain,nausea,vomiting,abdominal distension were the most common symptoms,and the abdominal tenderness,hypoactive bowel sounds were the most commn physical examinations.The levels of serum Amylases,WBC,CRP,TG were high and serum calcium was low.The sensitivity of SAP's diagnosis with CT is obviously higher than B-ultrasound.97.5%of 40 patients with SAP were recovered by medical,and only 2.5%by surgical operation,no body died.Individual comprehensive therapy is important in SAP.