Therapeutic effect of daytime continuous blood purification combined with plasma exchange on non-biliary severe acute pancreatitis / 中华肾脏病杂志

ABSTRACT

Objective@#To investigate the clinical efficacy of daytime continuous blood purification (DCRRT) combined with plasma exchange in the treatment of severe acute pancreatitis.@*Methods@#The clinical data of 49 patients with non-biliary severe acute pancreatitis admitted to the First People's Foshan Hospital from January 2012 to January 2019 were analysed respectively. The enrollees were randomized into DCRRT combined with plasma exchange (combination therapy) group and DCRR only (DCRR) group using a random number table method. All patients received DCRRT therapy [8 hours continuous venous-venous blood purification/day (CVVH/d)] immediately after the diagnosis of non-biliary severe acute pancreatitis was established. The combination group received at least one plasma exchange during the course of treatment. The differences of laboratory examination and prognosis between the two groups before and after treatment were compared.@*Results@#A total of49 patients were enrolled, including 29 males and 20 females, with age of (46.40±17.81) years. There were 24 patients in the combination therapy group and 25 patients in DCRR group. There were no significant differences in the age, gender, body mass index (BMI), and pre-treatment laboratory findings between the two groups. After treatment, the blood glucose, hypersensitive C-reactive protein (hs-CRP), procalcitonin (PCT-u), amylase, lipase, triglyceride, cholesterol, serum creatinine were lower than those before treatment (all P<0.05). The blood hs-CPR, PCT-u, lipase and triglyceride in the combination therapy group were significantly lower than those in the DCRR group (all P<0.05). The acute physiology and chronic health scores (APACHEⅡ) of the two groups were lower than those before treatment, and the combination therapy group was more significant than DCRR group (all P<0.05). There were 5 deaths (20.83%) in the combination therapy group and 7 deaths (28.00%) in DCRR group. There was no significant difference in mortality between the two groups. There was no significant difference in the start time and duration of DCRRT between the two groups.@*Conclusions@#DCRRT or combined plasma exchange therapy can effectively treat non-biliary severe acute pancreatitis. DCRRT combines with plasma exchange therapy can more effectively remove inflammatory factors and reduce APACHEⅡ score.