Acute Pancreatitis: Literature Review, Routine Of Diagnosis And Treatment

Objective:As people' s earting habits changed these years, the incidence of acute pancreatitis(AP) appeard to be rising. The study concluded and summarized the routine of acute pancreatitis after reviewing correlative literature. At the same time, through the retrospective study of the epidermiology and routine for diagnosis and treatment , we discussed the pathogeny laws, clinical characters and treatment routine of AP, which was hoped to be of help to the development in the period ahead.Methods:The case history information of AP inpatients treated in the 1st affiliated hospital of Guangzhou University of Traditional Chinese Medicine from May 1995 to May 2005 was collected for retrospective study.The information included: pathogeny, ages, seasons, drugs, fees and prognosis ect, which was used to have statistical analysis according to their belonging to measurement data or numeration data. Then tried to conclude the epidermiology information and measures of diagnosis and treatment , and had a pilot study of the standardized precept .Conclusion:1. epidemiology information:Biliary passage diseases, surfeit, alcohol, hyperlipemia and specific factors were the main pathogenies in the past 10 years in the hospital, which were consistent with that in our country. The disease happened in spring and winter chiefly. And there' s no significant difference in biliary passagedisease patients according to the gender, but the alcohol factors.2. Diagnosis:Characters of AP syndromes: pain of midsection(durative or paroxysmal), nausea or/and vomit, constipation, and/or fever.Physical sign:upper abdominal tenderness^ peritoneal irritation decreased bowel sounds ect.To collect the most remarkable abnormal laboratory results in 48 hours after admission . In application of binary Logistic( Backward:LR )to screen leucocyteN hemodiastases FBG> blood potassiunu TB> DB> blood calciunu AST ect. in SAP and MAP group respectively. And the variables reserved were serum potassiunu calciunu GLlk CREAn GGT and DB. The statistical results showed that the degree of AP had a negative relationship with blood potassium and calcium, and at the same time it had the close linkage with the levels of GLU and the renal and hepatic disfunction.Score patient' s information after admission in use of three remarking system such as Apache—II> Rason and Imrie. Then the score was processed in the discriminant analysis. In terms of the diagnostic effect in SAP in basis of ROC curve and area under it, Imrie was superior to Rason., while Rason to Apache—II. It' s demonstrated that the standards had a lower sensitivity (38. 7%—58.1%) but higher specificity (88. 6%~98.9%) compared with the critical points to classify SAP and MAP in three remarking systems remarked in literature.3. TheraputicWestern medicine: conserved therapy was account of 91. 2% in recent years. On basis of basic treatment, the fasting time to MAP (4.39 + 2.782 days) was strikingly diferent from that of SAP (6. 71+4. 627days). However, in lack of paying attention to nutritional support, only PN was adopted . In process of drug treatment, pancreatic exocrine inhibitors was condsiered as the chief way, or associated with pancreatic enzyme inhibitors. In view of the majority of the pancreatic onset related with biliary tract infection inland, antibiotics was 100% applied. Under this conditions, the application of antibiotics wasn' t standard yet.Theray on TCM: 75.9% of patients after admission took Chinese medicine, evenpart of patients put "to fast food but herbs" into effect. The therapeutic guideline equaled to "unobstructed six fu organs are regarded as unhindered and nourished, while pain with obstruction. " In addition, when conditions of disease emerged to the change in severe stage, coped with the problem of origin in time. According to the syndromes, the process of disease was classified into 3 periods including early> developing^ severe period. On basis of determination of treatment based in pathogenesis obtained through differentiation of syndromes and habitus, concrete therapy was carried out. Besides of oral adiministration, many ways such as intravenous drip^ coloclysis> acupuncture and moxibustion ect were also used to enlarge the therapeutic means of TCM in acute pancretitis.