[Individualized and comprehensive therapy for severe acute pancreatitis in early stage: analysis of 110 cases].
OBJECTIVE
To investigate the risk factors of exacerbation of severe acute pancreatitis (SAP) in early stage, in order to formulate therapeutic strategies including minimally invasive intervention and organ support, and to finalize an individualized and comprehensive therapy for the SAP in early stage to decrease the mortality.


METHODS
Fifty-three patients with SAP admitted from 1995 to 1999 was categorized as group 1, and 57 patients admitted from 2000 to 2005 as group 2, were analyzed retrospectively. Ranson's score, acute physiological and chronic health evaluation II (APACHE II) score, Balthazar CT grade, presence or absence of biliary tract obstruction, hypoxia, lung infection, shock, abdomen compartment syndrome (ACS), hyperlipemia, pleural effusion were analysed logistically. Mortality following different treatments and incidence rate of complications were also evaluated.


RESULTS
In the two groups, 13 patients of the group 1 and 14 of group 2 were complicated with multiple organ dysfunction syndrome (MODS) in the early stage. There was difference in Ranson's score, APACHE II, Balthazar CT grade, between the groups with and without MODS (all P<0.05). Higher incidences of shock, biliary tract obstruction, ACS, hyperlipemia, pleural effusion were seen in group with MODS (P<0.01). Mortality of group 2 patients was lowered after receiving a comprehensive therapy including bedside hemodialysis (CBP) and artificial liver support (P<0.01).


CONCLUSIONS
Development of MODS in SAP and its mortality are related to strategies of treatment, and adoption of an individualized and comprehensive therapy for the SAP in early stage can decrease the complications and the mortality.
Liu
Bao
B
Department of Critical Care Medicine, Anhui Provincial Hospital, Hefei 230001, Anhui, China.
Pan
Ai-jun
AJ
Zhou
Shu-sheng
SS
Wang
Hua
H
Shao
Min
M
Zhang
Lin-lin
LL
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors