| Objective: To analyze the general information and clinical laboratory data of 117 moderate patients with severe acute pancreatitis(SAP) enrolled from the First Affiliated Hospital of Dalian Medical University, we summarize impact factors of severe acute pancreatitis complicated with acute lung injury(ALI) and comparative clinical efficacy of combined traditional Chinese medicine Qingyitang, which provides reliable scientific basis and clinical experience for further improvement of the diagnosis and treatment, enhancing therapeutic effects and reducing mortality of severe acute pancreatitis complicated with acute lung injury.Methods: To collect clinical data of 117 patients with SAP, which enrolled from the First Affiliated Hospital of Dalian Medical University from January 2005 to January 2015, we estimate its general admission after they went to hospitalized, observe influencing factors of ALI, the variables including the cause of SAP, stages of SAP,the different CT grade, Ca2+ concentration,ALB concentration,the levels of WBC,PMN,AMS,UAMY,and duration of the systemic inflammatory response syndrome(SIRS). The relationship of TCM-WM and prognosis was also studied. These data were statistically analyzed with logistic regression analysis.Results:1.Biliary disease is the main cause of SAP including 56 cases(48%),followed hyperlipidemia SAP including 19cases(16.2%) and alcoholic SAP including 9 cases(7.6%).There is significant difference of mortality of ALI due to hyperlipidemia SAP(P<0.05). 2.The incidence of ALI was significantly higher in patients with SIRS compared with those no SIRS(P<0. 01).The duration of SIRS less than five days, there are 5 cases(11.1%) of ALI. The duration of SIRS is between five days to ten days, there are 15 cases(60.0%) of ALI. The duration of SIRS more than ten days, there are 21 cases(87.5%) of ALI. 3.There was a significant correlation between ALI occurrence and the CT classification, calciumion(Ca2+) concentration, albumin(ALB) concentration, whiteblood cell count(WBC) and neutrophils count(PMN),whether there is hydrothorax or not(P<0.05).There are no significant differences of age, sex,blood amylase(AMS),amylase in urine(UAMY),(P>0.05). 4.There are 32cases(78%)with ALI in the acute stage of SAP. There are 5 cases(12.2%)with ALI in the progressive stage of SAP. There are 4 cases(9.8%)with ALI in the infection stage of SAP. Different stages of SAP were significantly related to the incidence of ALI(P<0. 05). 5.Albumin concentration, calciumion concentration and SIRS went into unconditional multivariate Logistic regression analysis equation. 6.There are 41 patients of SAP with ALI, include 17 cases treated with traditional Chinese medicine and western medicine, and 24 cases treated with western medicine.After five days of ALI, Chinese medicine treatment group blood gas analysis index is obviously superior to Western medicine treatment group(P<0.05).There are 4(23.5%)deaths in traditional Chinese medicine and western medicine treatment group and 8(33.3%)deaths in western medicine treatment group. It is not significantly shortened between two groups(P>0.05).Conclusion:1. Biliary disease is the main cause of SAP,followed is hyperlipidemia and alcoholic. Hyperlipidemia is an important factor that has strong influence on incidence of ALI. 2. The incidence of ALI is positively correlated with the duration of SIRS.3. The variables included the cause of SAP, stages of SAP, SIRS, different CT types, Ca2+ concentration, ALB concentration, WBC, PMN are influence factors of ALI. SIRS, Ca2+ concentration, ALB concentration are independent risk factors of SAP complicated with ALI. 4.The combine Chinese medicine Qingyitang in our hospital for SAP complicated with ALI is better than pure western medicine, this way can increasing cure rate of SAP complicated with ALI. |
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