Retrospective Clinical Study Of Severe Acute Pancreatitis

Objective: To explore the changes of the etiology of SAP, summarize the experiences of the evaluation of patients' condition and the treatment of SAP.Methods: One hundred and sixty cases of SAP were studied. The reasons for SAP were divided into biliary, alcoholic and others. The correlation between S-B scoring system and prognosis was analyzed. In order to evaluate the S-B scoring system's value of the assessment of the severity of SAP, comparison was made between S-B scoring system and APACHEII scoring system. Comparison was made between 79 cases who were treated by early operation and 81 cases who were treated non-operatively in the mean hospital stay, the incidence of complication and the mortality. In order to observe the curative effect with somatostain, comparison was made between 20 cases who were treated with somatostain and 40 cases who were treated without somatostain from 1997 to 2000 in the mean hospital stay, the incidences of complication and the mortality .Results: It was found that 107 cases (66.9%) of the SAP was caused by biliary reasons, 22 (13.8%) by alcoholic reasons and 31(19.3%) by other reasons. With the rising of the value of the S-B score, the mean hospital stay, the complication and the mortality ascend too. S-B scoring system can reflect the variation of the mean hospital stay better than APACHEII scoring system. In control study between operative and non-operative treatments, the score of the S-B were 11.90±4.02 and 11.35±4.50(P>0.05),the severity of SAP in two groups have no differences. The mean hospital stay and the mortality rate in non-operative group were fewer than operative group, while the complications in two groups have no differences. When compared between the patientstreated with somatostain and without somatostain, the score of the S-B were 12.58±3.87 and 11.35±4.50(P>0.05). The severity of SAP ,as well as the mean hospital stay, complication and the mortality have no differences(P>0.05).Conclusions: 1,In our country, the main etiology factors of SAP was biliary. Because of ERCP's being carried out widely nowadays,we should pay attention to the influence of ERCP .2,The S-B scoring system can reflect the severity of SAP, It could be applied to evaluate the severity of SAP and to determine the prognosis.3,In the earlier stage of SAP, the treatment should be non-operation, meanwhile, the patient should observed carefully, as soon as the indications of operation were found, an operation should be performed in time.The open decompression of pancreatic envelope with lasting abdominal flushing and drainage may be beneficial in the earlier stage of SAP. 4,When patients had occured SIRS, it could have no affection in the mean hospital stay, the complication and the mortality if they are treated by somatostain only.