Clinical Analysis Of Treatment Of Severe Acute Pancreatitis With Blood Purification

Objectives To study the mechanisms of treating severe acute pancreatitis(SAP)with blood purification.Methods Ten SAP patients were chosen and treated with comprehensiveness therapy,at the meantime undergoing with continuous veno-venous hemofiltration(CVVH).The first persistence time was 20～24h,and then changed to 10～14h.Clinical symptoms,Blood biochemical indexes, gas analysis were tested pre-,intra- and post-treatment of CVVH.Meanwhile, APACHEⅡscores were graded.Results Compared with pre-treatment,fever, respiratory embarrassment,tachycardia,abdominal pain,and abdominal distention were released significantly.The results among all ten patients were not statistically significant.The average APACHEⅡscore of eight discharged patients before CVVH was 15.4±4.1,but decreased to 13.0±3.6,12.1±4.4,9.4±3.8 at the 12th,24th,48th hour after CVVH,respectively(P＜0.05).Blood routine,serum amylase,hepatic and renal function,electrolyes,CRP,endotoxin,blood glucose were improved.The blood gas analysis showed that hypoxemia and acid-base equilibrium disorders were also improved(P＜0.01).Eight patients were fully recovered from SAP and left hospital with a survival rate of 80%,while two died of multiple organ dysfunction syndrome(MODS).Conclusions Severe acute pancreatitis is one of the common critical diseases in ICU,with a high death rate and complication incidence rate. CVVH could efficiently alleviate the clinical symptoms,improve the serology indexes, and reduce the length of stay of SAP patients.