Effect of continuous renal replacement therapy on the control of different grades of intra-abdominal hypertension in patients with severe acute pancreatitis
10.3760/cma.j.issn.1671-0282.2023.11.013
- VernacularTitle:持续肾替代治疗对重症急性胰腺炎患者不同等级的腹内高压控制的效果研究
- Author:
Yi HANG
1
;
Jun ZHU
;
Ying YE
;
Weichao DING
;
Jie KANG
Author Information
1. 徐州市中心医院急诊科，徐州 221009
- Keywords:
severe acute pancreatitis;
Continuous renal replacement therapy;
Intra-abdominal pressure;
Intra-abdominal hypertension
- From:
Chinese Journal of Emergency Medicine
2023;32(11):1501-1505
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the effect and clinical significance of continuous renal replacement therapy (CRRT) on severe acute pancreatitis complicated with different grades of intra-abdominal hypertension, and to determine whether the level of intra-abdominal pressure can be used as one of the indicators of CRRT in these patients.Methods:From September 2020 to September 2022, the clinical data of 66 patients with severe acute pancreatitis complicated by intra-abdominal pressure (IAP) ≥12 mmHg who were treated with CRRT and admitted to the EICU of Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. According to the level of IAP, they were divided into group A: 12 mmHg≤IAP < 15 mmHg, 22 cases; group B: 15 mmHg≤IAP≤20 mmHg, 23 cases and group C: IA P>20 mmHg, 21 cases. The general clinical data and IAP values before and after CRRT treatment, as well as the ΔIAP (difference of IAP before and after treatment) were recorded. The difference of IAP before and after treatment and the ΔIAP between group B and group C were compared by independent sample t test. The relationship between IAP before treatment and ?IAP was analyzed by spearman test. Results:There were no significant differences in gender, age, modified Marshall score, APACHE Ⅱ score, number of mechanical ventilation, and etiology among the three groups before treatment( P>0.05). After CRRT treatment, IAP of group A was no significantly changed before and after treatment ( P>0.05). IAP in groups B and C was significantly lower after treatment than before treatment ( P<0.05), and the ΔIAP of group C was significantly higher than that of group B ( P<0.05). There was a positive correlation between IAP before treatment and ?IAP in group B and Group C ( P<0.05). Conclusions:1．For patients with severe pancreatitis complicated with intra-abdominal hypertension, CRRT treatment can effectively reduce IAP when IAP≥15 mmHg, and the higher the IAP, the more obvious effect of CRRT treatment in controlling intra-abdominal pressure. 2. IAP≥15 mmHg can be used as one of the indicators for CRRT in SAP patients.
