The Clinical Characteristics And Evaluation Of Severity In Severe Acute Pancreatitis (a Repart Of99Cases)

Objective:To study retrospectively the clinical features and treatment of patients withserious acute pancreatitis (SAP)，and their conditions and prognosis are evaluatedaccording to APACHEII score，Ranson score and Balthazar CT scale.Methods:The99cases of SAP patients were admitted in the first affiliated hospital ofDalian Medical university in2008-2012years. To study retrospectively the relationshipbetween SAP and APACHEII score，Ranson score and Balthazar CT scale，and toexplore the effects of three different methods on SAP prognosis early.Results:1. The three most important causes of SAP is biliary tract disease (41.4%)，hyperlipidemia (21.2%) and alcohol (5.1%)，and the mortality rate caused by variousof causes showed no significance，P>0.05.2. The positive rate of APACHE II was52.5%at24h，which of47cases gotscore between0and8(47.5%)，one of whom died(2.0%)， while score of33cases was8-14(33.3%)，and6patients died (18.0%). More than14score occupied19patients(10.0%)，10cases of whom died(52.6%). The mortality rate among three groupspresented statistical significance，P<0.05. The positive rate of Ranson score was70.0%(69/99), and the mortality rate among0-3,3-5and more than5score had significance，P<0.05. It was the highest in more than5score group. The positive rate of BalthazarCT scale was90.0%(90/99), and the mortality rate is the highest in E scale. There is nosignificant between D scale and C scale. Above all，the positive rate of Balthazar CTscale is the highest and the most sensitive among three kinds of score system.3. The81patients were cured and17cases died. The60of72cases were cured by conservative treatment (83.3%) while23of27cases were cured by surgery (85.2%).The death rate was18.1%(13/72) and14.8%(4/27) respectively by conservativetherapy and surgery. The5patients had an emergency operation，and2cases died while22patients had delayed surgery and2cases died. There is no significance not onlybetween conservative treatment and surgery but between emergency and delayedoperation.Conclusions:1. The main causes of SAP is biliary tract disease， and others includehyperlipidemia and alcohol. No significant relationship was found between differentetiology and mortality.2. Balthazar CT scale is the most sensitive methods among three kinds of scoresystem when evaluate SAP.3.MODS is the main death cuase of early SAP,especially incidence rate of acuterespiratory dysfunction and acute renal failure is higher.Therefor it is a key to controlMODS to decline mortal rate of SAP.4．Non-operation treatment should be considered in early stage of SAP. Themortality of SAP in our Hospital is similar to international level.