[Clinical study on severe acute pancreatitis complicated by hepatic insufficiency].
OBJECTIVE
To investigate the pathogenic factors of severe acute pancreatitis (SAP) complicated by hepatic insufficiency, the prognosis and the effective preventive and therapeutic interventions.


METHODS
One hundred and fifty-two patients with SAP (from January 2003 to June 2004) were divided into 2 groups, SAP with hepatic insufficiency group and SAP without hepatic insufficiency group. The related factors such as causes of disease, serum biochemical criteria, complications, mortality and course of disease were observed.


RESULTS
The concentrations of serum amylase, creatinine and lactate dehydrogenase were all much higher in the SAP with hepatic insufficiency group than those in the SAP without hepatic insufficiency group (P<0.05). The incidences of complications such as acute renal failure, heart failure, gastrointestinal hemorrhage and infection were also higher in the SAP with hepatic insufficiency group than those in the SAP without hepatic insufficiency group (P<0.05). There was no significant difference in mortality between these two groups, but the course of disease in SAP with hepatic insufficiency group was longer than that in the other group (P<0.05).


CONCLUSIONS
The causes of SAP complicated by hepatic insufficiency are related to the imbalance of internal environment and the characteristics of the liver function. To control the biliary tract diseases, intervene with traditional Chinese medicine, recover the intestinal function in time, reduce the damage of pancreatic enzyme, maintain the stability of internal environment and avoid using drugs that can induce liver injury are all important aspects of reducing the incidence of hepatic insufficiency.
Zhang
Hong-Yan
HY
Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041,China.
Xia
Qing
Q
D000328:Adult; D000681:Amylases / Q000097:blood; D003404:Creatinine / Q000097:blood; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D005260:Female; D048550:Hepatic Insufficiency / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications* / Q000188:drug therapy; D008517:Phytotherapy; D011379:Prognosis
D004365:Drugs, Chinese Herbal; D003404:Creatinine; D007770:L-Lactate Dehydrogenase; D000681:Amylases