The observation of curative effect of CBP at bedside for pregnancy complicating SAP / 中国医学装备

ABSTRACT

Objective: To explore curative effect of bedside continuous blood purification (CBP) for pregnancy complicating severe acute pancreatitis (SAP). Methods: 85 patients with pregnancy complicating SAP were divided into observation group (n=45) and control group (n=40). Patients of control group received series of symptomatic and supportive treatment included surgical termination of pregnancy, drainage, fasting, gastrointestinal decompression, fluid infusion, acid suppression, enzyme suppression and so on. And patients of control group were implemented the above treatments of control group combined with CBP at bedside. The acute physiology age and chronic health evaluation II (APACHE II) score, multiple organ dysfunction syndrome (MODS) score, the change of serum biochemical and inflammatory markers, and the mortality of pregnant woman and fetus pre and post treatment between the two groups were recorded and compared. Results: The mortality rates of pregnant women and fetus in the observation group was 4.44% 15.56%, and they were 7.50% and 20% in control group, respectively. The difference of mortality rate between the two groups were no significant. The APACHE Ⅱ score, MODS score, the serum levels of glutamic pyruvic transaminase (ALT), total bilirubin (TBIL), serum amylase (AMS), urea nitrogen (BUN) and creatinine (SCr) of observation group were significantly lower than that of control group at 72h after the treatment (t=11.13, t=9.79, t=17.79, t=12.55, t=10.13, t=15.25, t=12.29, P<0.05), while the PaO2/FiO2of observation group were significantly higher than that of control group at 72h after the treatment (t=11.44, P<0.05). Besides, the serum tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), procalcitonin (PCT), and C reactive protein (CRP) of observation group were significantly lower than those of control group at 72h after the treatment (t=17.25, t=14.29, t=12.44, t=11.29, t=13.44, P<0.05). Conclusion: CBP can effectively improve the clinical symptoms of patients with pregnancy complicating with SAP, and protect function of important organs, and improve blood biochemical indexes and remove inflammatory medium. Therefore, CBP is effective method which cure pregnancy complicating SAP, and it can effectively improve the state of this disease.