Early treatment with high-volume hemofiltration combined with rhubarb for patients with severe acute pancreatitis / 第二军医大学学报

ABSTRACT

Objective: To investigate the effect of early treatment with a combination of rhubarb and high volume hemofiltration for patients with severe acute pancreatitis(SAP). Methods: We retrospectively analyzed the 31 SAP patients, who were treated in our department between June 2005 and December 2007. Twelve patients (control group) received high-volume hemofiltration only and the other 19 patients(treatment group)received both hemofiltration and rhubarb-enchyma infused via a gastric tube for three days. The vital signs and recovery of gastrointestinal functions were observed in the two groups. The serum concentrations of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and plasma endotoxin were measured in the two groups. Results: The vital signs of all the patients were stable during the treatment. The APACHE II score and serum cytokine concentrations were significantly decreased in the two groups after treatment(P0.05). Gastrointestinal function of the treatment group recovered earlier, with an effective rate significantly higher than that of the control group(P<0.05). The plasma endotoxin of the control group were gradually elevated during the treatment; that of the treatment group increased first and then gradually decreased; and there was significant difference between the two groups (P<0.05). Conclusion: High-volume hemofiltration can clear the plasma inflammatory mediators and cytokines. Rhubarb can improve the gastrointestinal function and decrease the plasma endotoxin level of SAP patients; early treatment with a combination of both can improve the clinical outcomes of patients.