Effect Of Timing Of Abdominal Puncture And Drainage On Prognosis Of Moderate Severe Acute Pancreatitis

Objective To explore the effects of different abdominal puncture drainage timing on c-reactive protein（CRP）,Procalcitionin（PCT）,White Blood cell（WBC）,Interleukin6（IL-6）,Tumor necrosis factor α（TNF-α）and other laboratory indicators,hospitalization days,hospitalization costs,mortality,advanced rate,organ failure and other clinical indicators in patients with Moderate severe pancreatitis（MSAP）and ascites,Select the best APD time for MSAP patients with ascites.Methods A total of 84 MSAP patients hospitalized in Anqing Hospital affiliated to Anhui Medical University from September 2019 to May 2021 were collected.Twenty-eight patients（12 males and 16 females）were treated with APD within 0-3 days of admission.The average age was（56.32±13.31）years.Twenty-eight patients（13 males and 15 females）were treated with APD within 4-7 days after admission.The average age was（56.46±12.16）years.The remaining 28 patients were treated with non-puncture conservative treatment at admission,including 12 males and16 females,aged 31-72 years,with an average age of（56.50±13.48）years.There were no significant differences in gender and age between APD group and non-APD group within 0-3 days and APD group within 4-7 days（P<0.05）.Clinical data were collected on the extraction/admission of patients after puncture,1days,7 days,14 days,C-reactive protein,WBC,PCT,IL-6,TNF inflammation index,hospitalization days,hospitalization expenses and mortality,advanced,organ failure,etc.,and statistical tools were used to analyze and compare the differences of various methods.Results The fatality rate was 0% and the progression rate was 7.1% in the APD group within 0-3 days.The fatality rate and progression rate were 3.58% and 32.14% in the APD group within 4-7 days.The prognosis of non-APD group was 17.86% fatality rate and 35.71% progression rate.Organ failure in APD group was better than that in other groups within 0-3 days（P < 0.05）.WBC,CRP,PCT,IL-6 and TNF-α decreased significantly in APD group within 0-3 days after one week（P < 0.05）,and the hospitalization time and hospitalization cost in APD group within 0-3 days were shorter and lower than those in other groups（P < 0.05）.Conclusion For MSAP patients with obvious peritoneal effusion,the best early APD time is 0-3 days,which can significantly improve the prognosis of MSAP patients,reduce the level of inflammation,improve the survival rate and speed up the recovery of patients.