[Prognostic factors and treatment of severe acute pancreatitis]

Seventy two cases of severe acute pancreatitis (SAP) all documented by laparotomy. Fifteen were found to be of edematous and 58 of hemorrhagic and necrotic type, 29 cases died (39.7%). The following 6 items are of prognostic importance in both the survival and the dead groups: (1) Shock, (2) Serum albumin less than 30 g/L. (3) BUN greater than 7 mmol/L, (4) Blood glucose greater than 11.1 mmol/L, (5) Abnormal urine analysis, (6) PaO2 less than 8.6 kPa. Thirty two cases showed positivity of 3 or more of the 6 items, among them 21 died (65.6%). Fourty one cases had 2 or less positive items and 8 (19.5%) died. The mortality rate was not significantly different between the group who had either the edematous or the hemorrhagic necrotizing varieties. It was found that 88.2% of the patients in the dead group had hemorrhagic and necrotizing variety in the peripancreatic and similar pathology appeared in the survival group only in 50% (P less than 0.05). The risk was markedly increased in these patients with systemic complication in the lungs, kidney and brain. We found no effect of vasodilatation drugs (salvia miltiorrhiza and anisodamine) in the treatment of SAP.