To Investigate The Clinical Effectiveness Different Therapeutic Approach For Severe Acute Pancreatitis

Purpose: To investigate the clinical effectiveness of several therapy methods in treating severe acute pancreatitis ( SAP).Methods: To make a clinical retrospective review of 178 SAP patients,dividing them into 2 groups by the cause of disease. The first group was biliary SAP,and the second one was non-biliary SAP.Then divided to several group by therapy methods. The biliary SAP group including medical group and endoscope treatment group;the non-biliary SAP one including medical treatment group,hemofiltration group,the combination of hemofiltration with rhubarb group and the enteral nutrition group.It was observed to evaluate the clinical effect,the clinical symptoms and signs,the movement of index of lab,the rates of local complication,surgical treatment,mortality and hospitalization time.Results: The endoscopic treatment effect of biliary pancreatitis was better than a simple conventional medical treatment,the abdominal pain disappeared being more quickly, the direct bilirubin and APACHE-â…¡score decreased significantly after the treatment of day to 7 , the hospitalization time be shorter, with statistical significance (P <0.05 ). Rhubarb united hemofiltration treatment effect of non-biliary pancreatitis was better than conventional medical treatment.The time of first defecation, disappearance of abdominal pain, abdominal tenderness disappear and serum amylase turn negative was all shorter, WBC count and APACHE-â…¡score after the treatment to 7 day was better, the incidence of local complications and mortality has significantly changed, with significant difference (P <0.05), and no surgical treatment to patients in Rhubarb united homofiltration. Early use of enteral nutrition had no exacerbations in patient's condition, complications and death.Conclusions: The treatment of biliary SAP with endoscopic was better than non-endoscopic group. The treatment for non-biliary SAP with Rhubarb united hemofiltration can significantly reduce the clinical symptoms and the incidence of local complications and mortality;and early enteral nutrition in the clinical treatment was feasible and safe.