Effect of continuous large-volume hemofiltration combined with somatostatin on the prognosis of patients with acute severe pancreatitis
10.3760/cma.j.cn115455-20220607-00528
- VernacularTitle:持续大容量血液滤过联合生长抑素对急性重症胰腺炎患者预后的影响
- Author:
Nan WANG
1
;
Xiaoyan ZHANG
;
Yu SUN
;
Weige GAO
Author Information
1. 新疆维吾尔自治区人民医院重症医学科，乌鲁木齐 830001
- Keywords:
Somatostatin;
Hemofiltration;
Pancreatitis;
Prognosis
- From:
Chinese Journal of Postgraduates of Medicine
2023;46(12):1095-1099
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of continuous large-volume hemofiltration combined with somatostatin on the prognosis of patients with acute severe pancreatitis.Methods:A total of 106 patients with acute severe pancreatitis who were treated in the People′s Hospital of Xinjiang Uygur Autonomous Region from October 2019 to October 2021 were enrolled retrospectively and they were divided into drug group (53 cases) and filtration group (53 cases) according to different treatment methods. The patients in the drug group were given somatostatin instillation on the basis of routine treatment, and the patients in the filtration group were given continuous large-volume hemofiltration therapy on the basis of the drug group. The serum amylase level, clinical efficacy, clinical indicators and prognosis were compared between the two groups.Results:After treatment for 3 d and 1 week, the levels of serum amylase in the drug group were lower than those in the filtration group: (385.62 ± 15.57) U/L vs.(426.83 ± 18.21) U/L, (110.75 ± 7.68) U/L vs. (162.74 ± 9.12) U/L, there were statistical differences ( P<0.05). The total effective rate in the filtration group was higher than that in the drug group: 90.57%(48/53) vs. 75.47%(40/53), χ2 = 4.28, P<0.05. The hospitalization time, gastrointestinal decompression time and recovery time of bowel sounds in the filtration group were shorter than those in the drug group: (17.21 ± 4.01) d vs. (20.56 ± 4.57) d, (5.46 ± 1.56) d vs. (7.98 ± 1.79) d, (5.43 ± 2.11) d vs. (6.78 ± 2.54) d, there were statistical differences ( P<0.05). After treatment for 3 d and 1 week, the scores of gastrointestinal function and acute physiology and chronic health assessment (APACHE) Ⅱ in the filtration group were lower than those in the drug group: after treatment for 3 d: (1.64 ± 0.35) scores vs. (1.89 ± 0.41) scores, (23.42 ± 2.71) scores vs. (27.62 ± 3.01) scores; after treatment for 1 week: (0.67 ± 0.21) scores vs. (1.01 ± 0.32) scores, (9.78 ± 1.21) scores vs. (15.62 ± 1.58) scores, there were statistical differences ( P<0.05). After treatment for 28 d, the fatality rate in the filtration group was lower than that in the drug group: 5.66%(3/53) vs. 20.75%(11/53), χ2 = 5.27, P<0.05. Conclusions:Bedside continuous bulk hemofiltration with somatostatin in the treatment of severe acute pancreatitis can effectively reduce the serum amylase level, promote the recovery of gastrointestinal function, improve the clinical symptoms and prognosis.
