Study On Predisposing Factors Of Pancreatic Infection In Severe Acute Pancreatitis

Background and Objective Acute pancreatitis, inflammatory disease caused by digestive enzymes of the pancreas is abnormal activation of the pancreas itself and the surrounding organs of digestion produced Is a common acute abdominal symptom. Most cells in the pancreas digestive enzymes are not activated zymogen form which exists in the acinar cell zymogen granules zymogen. Trypsinogen in the slightly alkaline conditions can be automatically activated. To maintain the stability of trypsinogen of the zymogen granules in a weak acid PH.It is the key to maintain the normal function of the pancreas.Otherwise, any discomfort caused zymogen activation is an early occurrence of causative factors of acute pancreatitis. The acute pancreatitis is divided into mild and severe acute pancreatitis in the clinical pathology.Severe acute pancreatitis (SAP) is a is serious disease of danger ,complication and high mortality rates Severe acute pancreatitis(SAP) is serious disease of danger ,complication and high mortality rates . In the late of SAP ,there are more than 80% of patients died of sepsis and multiple organ failure (MOF). The incidence of sepsis MOF have closed relation with the necrosis of pancreas and secondary infection of surrounding tissue of pancreas ,which is the cause of late death . Therefore , the prevention of secondary infection of the pancreas , especially in the infection of necrotic pancreatic tissue, is the main objective of SAP treatment . To study the relation of the infection with various and pontential risk factors ,the mortality rate of SAP has not dropped significantly , even with the improved success rate of SAP treatment resulted from the application of a variety of surgical non-surgical treatment technology Therefore, the study on the SAP morbidity, predisposing factors , prognosis and so on in critically ill patients which will help improve the clinician's awareness of SAP and have a positive effect on effective prevention, prompt diagnosis and early treatment of SAP. In this way, the occurrence of the secondary pancreatic infection in SAP can be reduced or avoided, timely diagnosis, the patient's mortality will be reduced and the cure rate be higher. Moreover, it also plays an important role in reducing the patient's medical costs.Methods The research analyzes retrospectively one hundred and two patients with SAP in emergency surgery department from May 2008 to July 2010. The one hundred and two patients were divided into two groups, which occurs in patients with pancreatic forty cases of secondary infection, no infection in sixty-two patients, and a second generation of acute physiology and chronic health evaluation (APACHEⅡ) analyze it; At the same time, CT of patients , risk factors, serum amylase, intestinal function recovery, and admission blood cells hematocrit, serum calcium, blood glucose, serum albumin, hemoglobin concentration, and other related factors were analyzed; According to whether the infection in patients with SAP , they were divided into infection and non-infected group , the patients'clinical datum were compared between the infected group and the non-infected group. of the information used in homogeneity of variance single factor analysis of measurement data by t test. The comparison of the datum in two groups was conducted by usingΧ2 test. the analysis of multi-factors used logistic regression analysis.All datum was analyzed by statistical software SPSS13.0.Results The morbility of SAP secondary infection in emergency surgery departmentwas 39.22% And there are some statistical significantion(P<0.05 or P<0.01) between of thepatients of the infection and the non-infected group on admission ,such as APACHEⅡscore, serum calcium, intestinal dysfunction,≥5 days, hypoxemia, pancreatic necrosis, pancreatic infection complicated with MODS ,while patients have not significant difference (P> 0.05) in age, sex, serum amylase, blood glucose, serum albumin, hemoglobin and the risk factors (with non-biliary biliary).The APCHEII score of the infected group was higher than the non-infected group (P<0.01). The non-infected group compared admission ,the high infection group and non-infected group (P <0.01). The serum calcium (P <0.01) of the infection group was lower than the non-infection group, The occurrence of the hypoxemia (P <0.05) and concurrent MODS (P <0.05 ) in the infection group was higher than the non–infected group ,The rates of bowel dysfunction, the incidence of≥5 days was also higher than non-infection group. Performance in the abdominal CT, CT manifestations of infection in the percentage of necrosis was higher than non-infection group (P <0.05), patients with severe acute pancreatitis secondary to pancreatic infection related factors Logistic regression analysis showed: blood calcium levels, intestinal function disorder, pancreatic necrosis, and other factors combined with the secondary MODS had significantly relation with the secondary pancreatic infection.Conclusion Serum calcium level continued to decrease, bowel dysfunction, pancreatic necrosis , MODS and other concurrent infection may be the main predisposing factors of the secondary pancreatic infection.