ABSTRACT
Objective To investigate the efficacy evaluation of early continuous renal replacement therapy (CRRT) for severe acute pancreatitis in intensive care unit (ICU).Methods Prospective study was performed for 84 patients with severe acute pancreatitis admitted to the Xinjiang Provincial People's Hospital from June 2015 to March 2017.Those patients were divided into two groups by computer random coding:42 cases treated with CRRT (observation group), and 42 cases received routine treatment (control group).Statistically analysis was carried out between two groups regarding curative effect, symptom improvement, ICU hospitalization time, and serum markers before and after treatment.Results The total ef fective rate was 92.86 ％ in the observation group, and 85.71％ in the control group, without significant difference between two groups (F =0.516, P =0.632).Patients with symptoms, vital signs stable time, gastrointestinal function recovery time, and hospitalization time of ICU were significantly lower in the observation group than the control group [(3.16 ± 1.28) days:(5.21 ± 1.45) days, t =3.518, P =0.017, (2.55 ± 1.36) days:(4.34 ± 1.51) days, t =2.519, P =0.034, (4.46 ± 1.28) days:(6.28 ± 1.51) days, t=2.685,P=0.028, (15.06±2.24)days:(19.34 ±3.28) days, t=6.983, P=0.009].There is no significant differences in amylase (AMS), interleukin (IL)-6, C-reaction protein (CRP), tumor necrosis factor (TNF)α, prothrombin time (PT) and fibrinogen (FIB) before treatment between two groups (P ＞ 0.05).The observation group were significantly lower than the control group in AMS, IL-6, CRP, TNF-α, PT, and FIB levels after treatment [(206.59 ± 19.51) U/L:(258.12 ± 22.43) U/L, t =11.234, P=0.001, (34.58 ±6.41)ng/L:(41.36 ± 8.52) ng/L, t =4.121,P =0.013, (88.24 ± 6.95) ng/L:(104.33 ±10.82) ng/L, t=8.109,P=0.002, (178.35 ±27.43)pg/ml:(249.28 ±34.33)pg/ml, t=7.384,P=0.007, (12.48±3.54)s:(14.56 ±4.62)s, t =6.473,P=0.011, (3.38±1.55)g/L:(4.57 ± 2.86)g/L, t =4.108, P =0.041].Two groups of patients after treatment were cured, and no serious complications occurred during hospitalization.Conclusions For patients with severe acute pancreatitis, the overall effective rate of CRRT in ICU was high, the clinical symptoms relieved quickly, the level of serum indicators improved effectively.
ABSTRACT
Objective To investigate the clinical therapeutic value of CRRT on severe sepsis coincidence with capillary leak syndrome in surgical patients. Methods 38 patients suffering from severe sepsis coincidence with capillary leak syndrome were random divided into routine group ( n = 18 ) and CRRT group ( n =20). Both groups were given routine treatment, while the patients of CRRT group were given CRRT in addition. Red blood cell count (RBC), haematoglobin level, blood platelets count, leukocyte count, hematocrit (HCT), plasma-albumin level, central venous pressure ( CVP), arterial blood pressure ( ABP), urinary production change of every hour, oxygenation index condition ( PO2\FiO2 ) were measured at 0, 12, 24, 48,72 hour following routine treatment or CRRT. Additionally, serum levels of tumor necrosis factor- a (TNF-α), interleukin-6 (IL-6) and interleukin-8(IL-8) were determined at the same time. Results Blood platelets count, HCT, plasma-albumin level in CRRT group were significantly higher than those of routine group [72 h: (211. 75 ± 45. 23 ) × 109 vs ( 135.67 ± 41.45 ) × 109 ;0. 43 ± 0. 05 vs 0. 35 ±0. 04; (48. 60 ±4. 76) g/L vs (41.17 ±4. 64) g/L, P <0. 01 ]. WBC were significantly lower than those of routine group[72 h:(7.58 ±2.31) ×109 vs (13.77 ±2.67) × 109, P <0.01]. Change of ABP, PO2\FiO2, urinary production for every hour was notably increased than those of routine group [72 h: (94. 25 ±8.60) mmHg vs ( 84. 22 ± 7. 37 ) mmHg; 345. 25 ± 35. 21 vs 304. 22 ± 38. 74; ( 80. 15 ± 14. 54 ) ml vs (62. 72 ± 12. 33) ml, P <0. 01 ]. The serum levels of TNF-α, IL-6 and IL-8 of CRRT group were markedly decreased compared with those of routine group(72 h:249. 55 ±99. 60 vs 368. 83 ±97. 11 ;600. 75 ±98. 31 vs 718. 94 ± 92. 00 ;665. 35 ±138. 44 vs 843. 22 ±123. 95 , P <0. 01,P <0.05). Conclusions CRRT can significantly improve patient's condition, which may be an effective nechanism to treat the surgical patients with severe sepsis coincidence with capillary leak syndrome.