Clinical effect of blood purification and sustained glucocorticoid therapy on severe pancreatitis with respiratory distress syndrome
10.3969/j.issn.1009-9905.2017.06.006
- VernacularTitle:持续血液净化联合糖皮质激素治疗重症胰腺炎并发呼吸窘迫综合征的临床效果研究
- Author:
Hong LING
- Keywords:
Severe pancreatitis;
Respiratory distress syndrome;
Blood purification;
Dexamethasone
- From:
Chinese Journal of Current Advances in General Surgery
2017;20(6):444-446,450
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the clinical effect of blood purification and sustained glucocorticoid therapy on severe pancreatitis with respiratory distress syndrome,for providing clinical reference for such concomitant diseases.Methods:A total of 132 patients from April 2012 to June 2014in our hospital with severe pancreatitis and respiratory distress syndrome were studied,they were randomly divided into two groups,patients in the two groups were given conventional anti-infective,gastrointestinal decompression,rehydration therapy and other infrastructure,the control group were treated with continuous blood purification treatment,the observation group were treated with continuous blood purification and high-dose dexamethasone,the clinical symptoms,laboratory indicator in time,the levels of inflammatory cytokines,the APACHE Ⅱ scores and MODS scores and survival were compared.Results:The time of abdominal distention disappeared,blood amylase,urine amylase and pancreatic edema improvement in observation group was significantly improved than the control (P<0.05);when compared with before,the CRP,IL-6,IL-8 and TNF-α of two groups were significantly decreased,and the index in observation group decreased more significantly,the difference was statistically significant (P<0.05);when compared with before,the score of APACHE Ⅱ and MODS were significantly lower than control,the difference was statistically significant(P<0.05);The final survival rate in observation group was 90.8%,which significantly higher than 61.5% in control,the difference was statistically significant(P<0.05).Conclusion:The effect of continuous blood purification combined with glucocorticoids (eg dexamethasone) in patients with severe pancreatitis and respiratory distress syndrome is remarkable,the clinical symptoms can significantly improved,the levels of inflammatory factors,effective recovery laboratory indicators,APACHE Ⅱ score and MODS score were decreased,the survival was higher,it was worthy of clinical use.