A Clinical Study On Acute Severe Pancreatitis Complicated With Acute Lung Injury Treated With Integrative Chinese And Western Medicine

Objective To study on severe Pancreatitis complicated with lung injury,to explore risk factors of severe acute Pancreatitis(SAP)complicated with acute lung injury(ALI)in the acute Phase.To early diagnose ALI,decrease the fatality rate.To observe the influence of integrative Chinese and western on ALI/ARDS.Methods A retrospective analysis was conduced 51 Patients of SAP.The Patients divided into two groups according to the guideline of ALI(Group A for the Patients of ALI and group B for patients who did not suffer from ALI).The differences of blood pressure,blood glucose,drinking history were compared.The differences of termperature,resporitory rate,heart rate,pleural effusions of ALI were analysed.The variables of C-reactive Protein in 7 days after addimision were compared.The variables included the different CT types,Physiological index in 24h after admission,acute Physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score were studied.The correlation of acute lung injury with these variables was studied,and the independent risk factors of acute lung injury in SAP were explored using the single factor chi-square test analysis.The adult patients with ALI/ARDS divided into another two groups after the treatment:C group(the integrative Chinese and western medicine group)and D group(western medicine group)and those indicators were kept down,including the general situation,respiratory functional parameter,total hospital stays,and hospitalization expenses..Results Thirty-six case developed to acute lung injury in 51 Patients,and fifteen case did not suffer from ALI.The rates of tachypnea,tachyrhythmia,fever,Pleural effusions in ALI group were significantly higher than the other group.The levels of CRP were increased significantly in the first day of admission in two groups.The levels of CRP in group A were significantly higher than group B(P<0.05).There was a significant correlation between ALI occurrence and the cause of SAP,medcial history,CT classification,APACHE Ⅱ score,calciumion(Ca2+)concentration,albumin(ALB)concentratio-n,blood sugar concentration(GLU),white blood cell count(WBC)and neutrophils count(PMN).When serum Ca2+ was lower than 1.75mmol/L,the risk of ALI was increased 7 times.When ALB was lower than 30 g/L,the risk of ALI was increased 11 times.When APACHE Ⅱ≥15,the risk of ALI was 100 times higher than APACHE Ⅱ<8.The CRP level of the two groups on the first,second,third,seventh day had significant statistical differences when compared to the normal control group(P<0.01);when comparing the CRP level at the same time of C and D group,there was statistical significance in the difference(P<0.05).However,after comparing the CRP level at different time in the two groups,it was discovered that the integrative Chinese and western medicine treatment had a better capability in regulating the plasma and inflammatory factor than the western medicine treatment.Comparison in the respiratory functional indicators of the two groups:The difference in the PH,PaO2 and PaO2/FiO2 of the patients in two groups had statistical significance(P<0.05).Comparison the mean hospitalization days and hospitalization expenses in C and D group had statistical significance(P<0.05).Conclusions The study shows the high incidence rate of ALI in SAP.ALB concentration,Ca2+ concentration are independent risk of SAP complicated Avith ALI.The effect of integrative Chinese and western medicine in treating the ALI/ARDS is better than the regular western medicine.Integrative Chinese and western medicine can decrease the level of CRP,improve the recovery of oxygenation index.suggesting that the integrative Chinese and western medicine treatment plays a role in immune-regulation,promoting the recovery of respiratory function and alleviating the lung injury.