Simple peritoneal lavage combined with venous-venous hemofiltration for severe acute pancreatitis
10.3760/cma.j.issn.1674-1935.2011.01.004
- VernacularTitle:简易腹腔灌洗联合早期血液滤过治疗重症急性胰腺炎
- Author:
Tao DONG
;
Chunyan LUAN
;
Wei JIN
;
Jianmin XU
;
Yinhua ZHANG
;
Cunxin ZHAO
- Publication Type:Journal Article
- Keywords:
Pancreatitis,acute necrotizing;
Peritoneal lavage;
Venous-venous hemofiltration
- From:
Chinese Journal of Pancreatology
2011;11(1):8-10
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effectiveness of simple peritoneal lavage combined with venous-venous hemofiltration therapy for severe acute pancreatitis (SAP). Methods Needles were inserted into abdominal cavity and tee was connected, then normal saline was administrated and discharged, followed by lidocaine, dexamethasone and antibiotics once daily until bloody peritoneal drainage became clear. At the same time venous-venous hemofiltration was used. Results 61 SAP patients were randomly divided into peritoneal lavage + hemofiltration group (treatment group, n =31) and control group (n = 31). The time to abdominal pain relief, abdominal distention relief, nausea and vomiting disappearance, peritoneal irritation disappearance was (1.5 ±0.3)d,(2.7 ±0.3)d, (1.9 ±0.3)d, (1.5 ±0.2)d, and the time to cure was (11.0 ±2.0)d in the treatment group, which was significantly shorter than that in the control group [(3.9 ± 0. 3) d, (4.5 ±0.6)d, (3.7 ±0.2)d, (5.3 ±0.4)d, (18.0 ±2.5)d, P＜0.05]. At the 1st day of treatment, serum ALT,AST was significantly lower than that in the control group; at the 3rd day of treatment, the serum and urine amylase and serum levels of TNF-α, IL-6 and IL-8 level were significantly lower, but the serum level of IL-10,HCO3-was significantly higher than that in the control group (P ＜ 0.05 or ＜ 0. 01); at the 5th day of treatment, the serum Bun and Cr level were significantly lower than those in the control group (P ＜ 0. 05).Conclusions Simple peritoneal lavage combined with venous-venous hemofiltration therapy can effectively eliminate the inflammatory factors, which is more rational and effective for the treatment of severe acute pancreatitis.
