The clinical application of mirabilite abdominal hot compression bag for treating acute pancreatitis / 中华胰腺病杂志

ABSTRACT

Objective To explore the clinical application of mirabilite abdominal hot compression bag designed by ourselves for the moderately severe acute pancreatitis ( MSAP ) or severe acute pancreatitis ( SAP) .Methods Seventy MSAP and SAP patients were randomly divided into the observed and control groups according to the admission date.Each group included 35 patients.All the patients received the routine treatment.The patients in observed group received the treatment of compression action on abdomen by mirabilite abdominal continual hot compression bag designed by ourselves, while the traditional mirabilite hot compression action was used in the control group.The APACHEⅡscore and the levels of plasma CRP, IL-1, IL-6 and TNF-αof all patients on the 1st, 3rd, 6th, and 9th day after being admitted, the rate of complications including the intra-abdominal hypertension (IAH), pancreatic pseudocysts (PPC) and pulmonary infection, the recovery time of intestinal function and mean hospitalization time were all recorded and the therapeutic efficacy was compared between the two groups.Furthermore, the therapeutic effects of MSAP and SAP were compared between two groups.Results The APACHEⅡscore and the levels of plasma CRP, IL-1, IL-6 and TNF-αwere not statistically different between the two groups on the 1st day after hospitalization.The APACHEⅡscore and the levels of plasma CRP, IL-1 and TNF-αon the 3rd day in the observed group were significantly lower than those in the control group(P<0.05 or <0.01).The APACHEⅡ score and the levels of plasma CRP, IL-1 , IL-6 and TNF-αon the 6th day in the observed group were significantly lower, comparing to those in the control group.The levels of serum IL-1 and TNF-αin the observed groups were significantly lower than those in control group on the 9th day.All the differences above were statistically significant ( P<0.05 or <0.01).In the observed group, 4 cases (11.4%) had IAH and 7 cases (20.0%) developed other complications.The time of intestinal recovery and mean hospitalization was (4.9 ±0.8)d and (13.1 ±2.1)d, respectively, in the observed group.In the control group, 11 cases (31.4%) had IAH and 10 cases (28.6%) had other complications, and the time of intestinal recovery and mean hospitalization was (5.5 ±0.8) d and (15.4 ±3.9)d,respectively,.The rate of IAH, intestinal function recovery time and hospitalization time in the observed group were significantly less than those in control group (P<0.05 or <0.01).There was no statistical difference on other complications between the two groups.The intestinal function recovery time and hospitalization time of MSAPs in the observed group were significantly less than those in control group [(5.0 ± 0.8)d vs (5.5 ±0.8)d, P=0.03; (12.7 ±1.7)d vs (15.2 ±3.6)d, P=0.02].The APACHEⅡ score and the levels of plasma CRP, IL-1, IL-6 and TNF-αof SAPs were not statistically different between the two groups.Conclusions The application of the mirabilite abdominal continual hot compression bag could alleviate inflammatory response of MSAP and SAP, decrease the rate of IAH, improve the intestinal function recovery time,and shorten the hospitalization time.