Study On The Related Factors Of Pancreatitis Associated Ascitic Fluid Drainage On Gastrointestinal Motility

Objective Detect and compare the concentration of ascites and serum TNF-α、IL-6,concentration of serum VIP, MTL,iGIF scores between two groups that differentin peritoneal effusion on day1,3,5after drainage and compare the APACHEⅡscores，fthe arting time, the enteral nutrition time between two groups.Analysis correlationbetween the concentration of ascites TNF-α、IL-6and serum VIP, MTL,iGIF score inthe first day; To study the related factors of pancreatitis associated ascitic fluid ongastrointestinal motility disorder.Methods69patients with severe acute pancreatitis associated ascitic fluidswere admitted from Hunan Provincial People’s Hospital ICU，from May2011toOctober2013, male to female ratio41:28, mean age49±13years (18-80years old);iAPACHE Ⅱ score9-32points (17±5points);69patients will be divided intotwo groups according to the fluid drainaged on the first day.(drainaged fluid morethan500ml on the first day is divided into A group n=30; drainaged fluid less than500ml on the first day is divided into B group n=39), all paracentesis patients withascites admitted to ICU underwent bedside B-ultrasound positioning abdominalpuncture catheter drainage of ascites,drainage on day1,3,5, collected ascites andserum, Detect and compare the concentration of ascites and serum TNF-α、IL-6,concentration of serum VIP, MTL and iGIF scores between two groups thatdifferent in peritoneal effusion on day1,3,5after drainage and compare the APACHEⅡscores，the farting time, the enteral nutrition time between two groups.Analysiscorrelation between the concentration of ascites TNF-α、IL-6and serum VIP, MTL,iGIF score in the first day.Results (1) The APACHEⅡscores,the farting time, the enteral nutrition time ofgroup A were more than those of group B.(2)The concentrations of TNF-α,IL-6levelsin ascites were significantly higher than in the serum,there was a significant differencebetween the two.(3) The concentrations of TNF-α,IL-6in group A both in the serum and ascites were higher than those of group B,there was a significant differencebetween the two.the concentrations of TNF-α in both groups in the serum and asciteswere the highest in the first day,and then gradually decreased from third day to thefifth day; the concentrations of IL-6in both groups in the serum and ascites were thehighest in the third day,and then gradually decreased.(4) The concentrations of serumMTL in group A on1,3,5-day is lower than group B, the concentrations of serum VIPin group A on1,3,5-day is higher than group B; With the increase of the number ofdays after drainage, the concentrations of serum MTL on the rise in both groups, theconcentrations of serum VIP was going on a downward trend in both groups.(5) TheiGIF score in group A on1,3,5-day is higher than group B; With the increase of thenumber of days after drainage, the iGIF score was going on a downward trend in bothgroups.(6)The concentrations of TNF-α, IL-6in ascites of two groups in the first dayof the drainage correlated positively with concentrations of serum VIP and iGIFscores correlated negatively with concentrations of MTL in the serum.Conclusion (1) PAAF associated with gastrointestinal motility disorder andseverity of SAP.(2) TNF-α, IL6in PAAF are related factors with gastrointestinalmotility disorders of SAP.(3) drainage of PAAF is beneficial for restoration ofgastrointestinal motility of SAP.