Clinic Research Of Abdominal Surgical Diseases With ALI/ARDS

Objective:To observe and anslysis the relation of APACHEâ…¡,organ failure numbers,conventional biochemical tests, blood gas analysis,blood tests,endotoxin, TNF-a,IL-6 and prognosis. Discuss the relationship between the exterior and interior relation of lung and large intestinal and abdominal surgery disease with ALI/ARDS.From this study we want to explor the pathogenesis and treatment measures of abdominal surgery disease with ALI/ARDS, and finally improve the prognosis suevival rate of abdominal surgical disease with ALI/ARDS.Methods:To collect the record of 129 patients with ALI/ARDS admitted to the surgical intensive care unit in naikai hospital from 2008.6 to 2010.12. To collect clinical parameters and biochemical indicators of patients by unitied observational table. All patients received integrated Chinese and Western medicine treatment. Retrospectively analyzed the changed rule of APACHE II, organ failure numbers, endotoxin, TNF-a and IL-6 before the treatment and on the 3rd and 5th days after being treated.Result:1. we can find the primary original etiological factor of ALI/ARDS was severe acute pancreatitis.In 129 patients,the death was 77 and the mortality was 59.69%.2. From high to low, the incidence of different organs impairment were lung, kidney, gastrointestinal, brain, liver, heart, coagulation, circulation, metabolism.3. By single factor analysis, Our study showed that those with age, Past history, Organ failure numbers, PaO2/FiO2, PMN and APACHE II had a relatively higher mortatily. After logistic regression analysis, the main risk factors were age, PaO2/FiO2, the number of organ failure and APACHE II.4. The comparison of the different severities found that the organs with the functional lesions numbers, PMN, the level of the endotoxin, TNF-a and IL-6 almost have obvious differences (P<0.05). If the groups are divided on the basis of prognosis, APACHE II, the level of the endotoxin, PMN, TNF-a and IL-6 in the survival group descended on the 7th day after being treated, and it had statistical significances, but those indicators raises obviouely in the death group(P<0.05).Conlusion:1. We founded that the first death cause of abdominal surgery disease with ALI/ARDS is acute severe pancreatitis. The lung is the most easily suffered from function impairment in different organs.2. Organ failure numbers, age, APACHEâ…¡,the level of the endotoxin, TNF-a,IL-6 and PMN, as the significant indicator, may be used to judge poor prognosis of the abdominal surgical disease with ALI/ARDS. The main risk factors were age, PaO2/FiO2, the number of organ failure and APACHE II.3. In traditional Chinese medical, the exterior and interior relation of lung and large intestinal as the guide, on the basis of western treatment, giving qingrejiedu,promoting blood circulation to remove blood stasis, tongligongxia and so on. we should value highly of the gradually impairment of endotoxemia to organism and the functions of the traditional Chinese medicine, such as regulating the immune function, removing the endotoxin and protect the function of organs. The combined treatment of Chinese and Western medicine is to be the developing direction of the prevention and cure of the abdominal surgical diseases with ALI/ARDS.