Risk factors and therapeutic strategies for early stage severe acute pancreatitis in plateau

Objective To study risk factors and therapeutic strategies for early-stage severe acute pancreatitis(SAP) in plateau.Methods Two groups of patients from plateau and plain separately were studied.Group from plateau consisted of 63 SAP patients,and group from plain consisted of 64 SAP patients.General health condition,acute physiology and chronic healthy score(APACHEⅡ),hemoconcentration,shock,and hypoxia were analyzed using logistic analysis.Risk factors affecting the fatality rate of SAP in terms of treatment were analyzed.Results In the early stage the conditions were more severe in group from plateau than in group from plain with regard to hemoconcentration(HCT50%),hypoxia,shock,and multiple organ disfurbance syndrome(MODS) and the difference was significant(P0.01).The fatality in group from plain was lower than that in group from plateau because of changes in the therapeutic strategies including sufficient liquid resuscitation,mechanical ventilation,and abdominal drainage of abdomen compartment syndrome;and the difference was significant(P0.01).Conclusions Risk factors affecting high altitude SAP complicated by MODS in the early stage include hemoconcentration,shock,hypoxia and strategy of clinical management.Positive correction of hypoxia,sufficient fluid resuscitation,improvement of hemoconcentration,and inflammation control are crucial for preventing MODS in early SAP.