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Analysis and prevention of factors predisposing to infections associated with severe acute pancreatitis
1Department of General Surgery, First Clinical Hospital, Harbin Medical University, Harbin 150001, China. sunbei70@163.net
Objective:
To analyze factors predisposing to the infections associated with severe acute pancreatitis (SAP) and work out ways for their prevention.
Methods:
208 patients with SAP treated at our hospital from January 1986 to December 2001 were retrospectively analyzed.
Results:
Statistical difference in the incidence of the infections was found between the following pairs: the groups of bloody or non-bloody ascites, paralytic ileus lasting shorter or longer than 5 days, Ranson's scores lower or higher than 5, hematocrit lower or higher than 45%, CT Balthazar scores lower or higher than 7, and between January 1986-June 1992 or July 1992-December 2001 admissions (chi2>7.58, P<0.05), while no statistical difference established between the groups of biliogenic and non-biliogenic pancreatitis, serum amylase <200 U/L and >/=200 U/L, serum calcium <2 mmol/L and >/=2 mmol/L or groups of total parenteral nutrition shorter or longer than 7 days (chi2<1.61, P>0.05).
Conclusions:
Occurrence of infection in patients with SAP is closely related with bloody ascites, paralytic ileus (>/=5 days), Ranson's scores (>/=5), hematocrit (>/=45%) and CT Balthazar scores (>/=7), but not with pathogenesis, serum calium or total parenteral nutrition. Comprehensive prevention of pancreatic infection and individualized therapy may reduce the incidence of infection.
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