| Objective:To investigate the changes of etiology,diagnosis, and therapeutics in patients with severe acute pancreatitis(SAP) in recent ten years in western Guangxi, and its influence on prognosis,to sum up the experiences of the treatment of SAP.Methods:In this retrospective clinical trial,1291 cases of acute pancreatitis(AP) patients were admitted to the Affiliated Hospital of Youjiang Medical College for Nationalities and People’s Hospital of Baise,in which 243 cases of SAP were divided into two groups for analysis the changes of etiology, therapeutics regimens, complications and prognosis. Patients with SAP from January 2004 to December 2008 were recruited into the group A and those from January 2009 to December 2013 were group B.Result:LA total of 1291 cases of patients admitted to AP during the 10 years. There were 589 cases in the previous five years, of which 16.5% (97 cases) as SAP, classified as group A. There were 702 cases in the after five years, of which 20.8%(146 cases) was SAP, classified as B group.2.Comparing the etiology of the SAP two groups, biliary tract diseases was 37.1% in the group A and 36.1% in the group B, alcoholic factor was 24.7% and 27.6%, idiopathic factor was 21.6% and 17.7%, hyperlipidemia factor was 11.3% and 14.3%,respecttively.3.All patients were measured in serum amylase, patients having serum amylase levels greater than 3 times higher than the upper normal were 54.6% and 57.5%.respecttively.A, B groups, respectively 95.9% and 99.3% of patients received Computed Tomography(CT) scan, the positive rates was 66.2% and 80.1% respectively, the positive rate of B group was higher than group A (P<0.05). A, B two groups were 56.7% and 100% of the patients were measured C reactive protein (CRP), the positive rates was 62.9% and 67.1%.4.There are 26.8% and 19.2% respectively in two groups of patients for surgical treatment. However, in group A, the application of Intensive Care Unit(ICU) accounted for 25.8%, improvement of circulation accounted for 62.9%, the application of blood purification accounted for 16.5%, in group B, the application of ICU accounted for 38.4%, improvement of circulation accounted for 82.9%, the application of blood purification accounted for 28.1%.After 2009,to carry out enteral nutrition and Endoscopic Retrograde Cholangio-Pancreatography(ERCP) treatment.5.The effective rates of two groups were 74.2% and 84.9%,and the fatality rates were 15.8% and 6.2% respectively. The effective rates of group B is higher than group A, and the fatality rates is lower (P< 0.05). The incidence rates of pancreatic pseudo cyst and organ failure in group B (13.0%,21.9%,) were significantly lower than group A (23.7%,34.0%)(P<0.05). The cost of hospitalization and length of hospital stay between the two groups showed no significant difference.Conclusions:In recent ten years, the constituent ratio of SAP showed ascendant trend in western Guangxi and the etiology of SAP has no obvious change, biliary tract tlisease are still the main etiology of SAP. With the improvement of therapeutic regimens, the efficiency rate of SAP in western Guangxi is higher than before, and the incidence of complications and mortality rate are decrease obviously. The cost of hospitalization and length of hospital stay not improved. |
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