Retrospective Analysis Of 76 Cases Of Moderately Severe And Severe Acute Pancreatitis

Objective:By summarizing and analyzing clinical characteristics of diagnosis and treatment of patients with moderately severe and severe acute pancreatitis in hospital,Providing the basis for the clinical diagnosis and treatment.Methods: To collect the case data of 76 patients with moderately severe and severe acute pancreatitis in our hospital from January 2012 to June 2015,Retrospectively analyzing the data.To classify the general data,etiology and clinical manifestations.To compare the difference of BISAP score and image score in evaluating the severity of severe acute pancreatitis.Grouping the laboratory tests,complications according to the etiology,comparing the differences between the groups and analyzing the reason.To describe the treatment methods and outcome.Using the rate,Chi-square test,analysis of variance for statistical analysis.Results:76 cases of patients with moderately severe and severe acute pancreatitis,male 36 cases,female 40 cases,ratio is 0.9:1.Aged 23-89,the average age(57.9±15.1).MSAP 57 cases,SAP 19 cases,recurrence 10 cases.Gallstone 45 cases,Hyperlipidemia 6 cases,Alcohol 7 cases,Other reasons 18 cases.The patients' main clinical symptoms are abdominal pain,waist and back pain,abdominal distension,nausea and vomiting,fever,chest tightness and short breath.The main signs are tenderness,rebound tenderness,jaundice,bowel sounds less,MURPHY sign(+).BISAP score of 3 or more 51 cases,MCTSI score of 4 or more 76 cases,the difference was statistically significant.Variance analysis of laboratory tests showed that white blood cells and triglycerides was statistically significant difference between the groups,to compare the test between two groups in white blood cells showed that Gallstone group and Hyperlipidemia group,Gallstone group and Other reasons group was statistically significant,to compare the test between two groups in riglycerides showed that Hyperlipidemia group was statistically significant with each group,Gallstone group and Other reasons group was statistically significant.Main complications of Gallstone group was acute peripancreatic fluid collection(APFC),acute necrotic collection(ANC),pancreatic pseudocyst,pleural effusion,gastrointestinal obstruction,the liver function damage,multiple organ dysfunction syndrome(MODS);Main complications of Hyperlipidemia group was APFC,ANC,systemic inflammatory response syndrome(SIRS);Main complications of Alcohol group was more serous cavity effusion,acute lung injury,acute kidney injury,MODS;Main complications of Other reasons group was walled-off necrosis(WON),gastrointestinal bleeding,gastrointestinal obstruction,heart failure and arrhythmia,acute lung injury and acute kidney injury,MODS,coagulant function abnormality.Internal medicine treatment 46 cases,ICU treatment 28 cases,ERCP operation 3 cases,without surgical treatment.Treatment results: 59 patients were better when leave hospital,7 patients were automatic discharge,8 cases were transfered,2 cases died,the average hospitalization time was(25.6± 14.1)days.Conclusion:Patients with moderately severe and severe acute pancreatitis has a variety of causes,more complications and high fatality rate,it should be identified using a variety of criteria as soon as possible,and taking patients as the center for multi-disciplinary comprehensive treatment.