Effect of an early application of chaiqin chengqi decoction in treating severe acute pancreatitis complicated with acute respiratory distress syndrome / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effects of an early application of Chaiqin Chengqi Decoction (CQCQD) on severe acute pancreatitis (SAP) complicated with acute respiratory distress syndrome (ARDS).</p><p><b>METHODS</b>Forty patients of SAP-ARDS were equally randomized into the early-treated group (ET) and the late-treated group (LT), CQCQD was administered to them immediately and 3 days later after hospitalization respectively. Baseline materials in the two groups at the entry were insignificantly different (P > 0.05), and the same conventional Western medical therapy were available to them all. The Acute Physiology and Chronic Heath Evaluation II (APACHE I) scores, the incidence and sustained time of complications, the occurrence of infection, requirement of operation shifting on day 7, as well as the duration resided in hospital and mortality in patients were observed and compared.</p><p><b>RESULTS</b>Comparisons of the above-mentioned clinical indexes between groups showed that the APACHE II score was lower (5.1 +/- 2.0 scores vs 9.3 +/- 4.3 scores, P < 0.01); the incidence of shock was lesser (1/20 vs 7/19); the duration of ARDS, renal failure, cardiac insufficiency, hepatic dysfunction, cerebropathy and enteroplegia, as well as the duration in hospital and the requirement of operation shifting were all shorter significantly (P < 0.05) in the ET group than those in the LT group, but no statistical difference (P > 0.05) was shown in terms of the infection incidence and the mortality.</p><p><b>CONCLUSION</b>An early application of CQCQD in the treatment of SAP could shorten the duration of complications and the couse of disease, lower the requirement of operation shifting. But further study with large samples for explore its impact on the infection incidence and the mortality is needed.</p>

Risk factors and infection characteristics of secondary pancreatic infection in severe acute pancreatitis / 中华外科杂志

<p><b>OBJECTIVE</b>To explore risk factors and infection characteristics of secondary pancreatic infection in severe acute pancreatitis (SAP).</p><p><b>METHODS</b>A clinical data of 49 patients with secondary pancreatic infection in severe acute pancreatitis (SPI group)were matched with 49 patients without infection in severe acute pancreatitis (NSPI group) between January 2003 and December 2005. The two groups were analyzed by a case-control study. Conditional Logistic regression model univariate and multivariate were used to screen out risk factors. The types of infection, the peak infection and the bacteria spectrum were analyzed in SPI group.</p><p><b>RESULTS</b>(1) In univariate Logistic regression analysis, 7 factors including continuous hypoalbuminemia, prolonged time of central venous catheter, usage of hormone, high APACHE II scores, multi-antibiotics, intestine dysfunction and continuous hyperglycemia were selected out. Moreover, the first three were statistically significant in multivariate Logistic regression analysis. (2) Pancreatic abscess ranked first in SPI group. Of all the pancreatic infection, 22.5% occurred within two weeks and 71.4% occurred in the 4th week or later. (3) In SPI group, 81 strains of microorganisms were cultured, including 45 strains of gram-negative bacteria (55.6%), 22 strains of gram-positive bacteria (27.2%), and 14 strains of fungi (17.3%). The common gram-negative bacteria were Escherichia coli, and the common gram-positive bacteria were Staphylococci and Enterococci. The fungi included Monilia and Yeastoid fungus. Further study revealed that 35 strains of all the microorganisms were intestinal bacteria (43.2%).</p><p><b>CONCLUSIONS</b>Continuous hypoalbuminemia, prolonged time of central venous catheter and usage of hormone were independent risk factors of SPI. The main type of infection was pancreatic abscess. Gram-negative bacteria, were the common bacteria causing secondary pancreatic infection.</p>