The effect of early continuous blood purification combined with abdominal minimally invasive drainage on gastrointestinal motility in acute reaction period and prognosis of severe acute pancreatitis
GAO Fei
QIAN Ming-jiang
FU Xiao-yun
Abstract：Objective To observe the effect of continuous blood purification combined with abdominal minimally invasive drainage on gastrointestinal motility in patients with severe acute pancreatitis. Methods This retrospective study included 62 cases of severe acute pancreatitis patients, and they were divided into three groups, according to the different treatment options. Group A:patients were treated without continuous blood purification or abdominal minimally invasive drainage during the first 48 hours(n=18). Group B:Patients were treated with continuous blood purification combined with abdominal minimally invasive drainage during the first 24 hours(n=23). Group C:Patients were treated with blood purification and without abdominal minimally invasive drainage during the first 24 hours ( n=21). The patients were recorded the following indexes, intra - abdominal pressure, gastrointestinal decompression, APACHEⅡscore, C-reactive protein ( CRP) , blood lactate, bowel sounds, weight of stool,at the time of 0,24,48 h after admission. Mechanical ventilation and the average hospitalization time and the average cost of treatment in ICU, the number of organ dysfunction and mortality in 28 days, 60 days were recorded and compared among the groups. Results The intra-abdominal pressure and the amount of gastrointestinal decompression were decreased in the treatment of 24 h and 48 h with all groups. Compared with group A, group B and group C were significantly decreased, especially of group B [(13.6±1.8)cmH2Ovs(17.5±1.9)cmH2O; (678±87)mLvs(846±68)mL; P<0.05].The bowel sounds, the stool amount were increased in the treatment of 24 h and 48 h with all groups, especially of group B[(1. 57 ± 0. 08) times/min vs (0. 95 ± 0. 05) times/min; (365 ± 35) g/d vs (225 ± 30)g/d, P<0. 05]. APACHEⅡscore, CRP and blood lactate were decreased in the treatment of 24 h and 48 h with all groups. Compared with group A, group B and group C were significantly decreased, especially of group B[(14. 3 ± 1. 7) scores vs (16. 7 ± 2. 4) scores;(59. 5 ± 6. 5) ng/L vs (89.2±6.5)ng/L;(1.8±0.5)mmol/Lvs(4.6±0.7)mmol/L; P<0.05].ComparedwithgroupA and group C,group B in ICU mechanical ventilation and the average hospitalization time,the number of organ dysfunction and the average cost of treatment in ICU was significantly decreased[(158.6 ±7.4)h vs (191. 5 ± 8. 2)h vs (172. 5 ± 7. 8)h;(2. 3 ± 0. 5) vs (3. 5 ± 0. 6) vs (3. 4 ± 0. 6);(11. 7 ± 1. 7)d vs (15.5 ±2.1)d vs (12.6 ±2.2)d;(12.8 ±2.1) ×104 yuan vs (15.5 ±2.3) ×104 yuan vs (14.4 ± 1. 9) × 104 yuan;P<0. 05]. Conclusion Early continuous blood purification combined with abdominal drainage can effectively improve the gastrointestinal motility in patients with severe acute pancreatitis, can effectively alleviate the symptoms of gastrointestinal tract in the acute reaction period, decrease mechanical ventilation and the average hospitalization time, the number of organ dysfunction andthe average cost of treatment in ICU,improve prognosis of severe acute pancreatitis.
Keywords：Continuous blood purificationAbdominal minimally invasive drainageSevere acute pancreatitis( SAP)Gastrointestinal motilityPrognosis
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 513-516 )