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ObjectiveTo investigate the values of C-reactive protein (CRP) and pleural effusion in predicting the severity in the early stage of severe acute pancreatitis (SAP) . Methods A total of 89patients with acute pancreatitis were collected from October 2008 through October 2010 for retrospective analysis. Patients were divided into two groups, namely mild acute pancreatitis (MAP) group and SAP group as per the Guidelines for Clinical Diagnosis and Classification of Acute Pancreatitis set by the Society of Chinese Medical Association in 2003. The levels of CRP were measured on the 1st, 2nd, 3rd and 7th days after admission. Pleural effusion was also observed on the 1 st day after admission. The data of two groups were analyzed and compared. ResultsThere were significant differences in CRP at all intervals between SAP group and MAP group (P ＜0.05) . The relative risk of increase in CRP ( ＞ 150 mg/L),pleural effusion and increase in CRP along with pleural effusion were analyzed, and each of these three markers can be used as an independent severity factor of SAP. Particularly, increase in CRP along with pleural effusion could be most sensitive in predicting the severity of SAP with relative risk (RR) to be 4. 8 and specificity of predictive value to be 100％. ConclusionsC-reactive protein and pleural effusion are available, simple and economic biomarkers which can help us predict the risk of acute pancreatitis in the early stage.
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Objective To investigate the reason of intra-abdominal haemorrhage caused by severe a-cute pancreatitis (SAP) and its nursing experience. Methods A retrospective study was carried out in 19 patients with intra-abdominal haemorrhage after SAP surgery in the Second Affiliated Hospital of Harbin Medical University from March 1998 to March 2007. Results All other patients received good hemosta-sis effect except one case,who showed no effect with hemostatic drug and local compression,but at last showed effect by transfixion under direct vision. Conclusions Intra-abdominal haemorrhage after SAP surgery has high mortality rate. It should be dealt with in a timely manner with a view to improve the prog-nosis of patients.
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Objective To evaluate the clinical significance of phural effusion and/or ascites and their prognostic role in patients with acute pancreatitis.Methods The clinical data of 312 patients with acute pancreatitis were collected and analyzed retrospectively.Results Pieural effusion was found in 47 patients and ascites in 18.of 47 cases with pleural effusion,there were 31 cases(65.9%)of severe pancreatitis(P＜0.01)and 27 cases (57.4%)complicated by pseudocyst(P＜0.01).Among 18 cases with ascites,there were 14 cases(77.7%)of severe pancreatitis(P＜0.01).6 cases with pleural effusion and/or ascites died of multiple organs failure.Conclusion Pleural effusion and/or aseites is closely associated with severe pancreatitis.
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Objective To investigate the effects of pioglitazone,a peroxisome proliferation activated receptor(PPAR)γ agonist on oxidative stress process and the therapeutic effects on severity of acute pancreatitis(AP).Methods Thirty male Sprague-Dawley rats were randomly divided into five groups with 6 in each:control group,eerulein plus pioglitazone group,cerulein group,cerulein plus vehicle group,cerulein plus pioglitazone and GW9662 group.Rats were sacrificed at 30 min after the induction of pancreatitis.Pathologic changes of the pancreas were observed under light microscope.The ratios of pancreatic wet/body weight of rat were determined in each group.Serum amylase,pancreatic nitric oxide synthase(NOS),inducible nitric oxide synthase(iNOS),malondialdehyde(MDA),and myeloperoxidase (MPO)were determined by chromometry.Results The serum amylase,pancreatic wet/body weight and the score of pathologic damage increased after the induction of pancreatitis,AP samples were characterized by increased pancreatic MDA,MPO,NOS and iNOS(P＜0.01).Pioglitazone(20 mg/kg and 40 mg/kg)exhibited a protective effect against oxygen free radicals reflected by lower serum amylase,less severe pancreatic lesions,normal pancreatic MDA,MPO and NOS levels(P＜0.05).GW9662 reversed the effects against oxidative stress of pioglitazone(40 mg/kg)(P＜0.05).Conclusions Pretreatment with pioglitazone may exert its therapeutic effect on AP by lowering pancreatic oxidative free radicals and reducing pancreatic tissue infiltration of neutrophils.
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Objective To discuss nursing of patients with early severe acute pancreatitis undergoing laparoscopic treatment and in comparison with open surgery. Methods Totally 56 patients with early se-vere acute pancreatitis were admitted from October 2002 to October 2007,among which 30 cases (group A) received laparoscopic.treatment and the other 26 cases (group B) was given open surgery.The average time of hospital stay,incidence of complication and re-operation were compared between the two groups. Re-sults The average time of hospital stay,incidence of complication and re-operation of group A were lower than those of group B (P<0.05). Conclusions Treatment of severe acute pancreatitis with laparoscopy proved to be a desirable method in that it performs good effect with little trauma and low fatality.Other basic treatment,regulation of water and electrolyte balance and acid-base balance,enforcement of nutritional sup-port,fasting and gastrointestinal decompression should not be ignored.