Zhang Wenhao, Sun Jiakui, Shen Xiao, Xue Yinying, Meng Chao, Yuan Shoutao
Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China -
Minerva Chir. 2019 Jun;74(3):207-212. doi: 10.23736/S0026-4733.18.07813-6. Epub 2018 May 29.
To investigate the efficacy of percutaneous catheter drainage (PCD) and peritoneal dialysis (PD) in the treatment of severe acute pancreatitis (SAP) and its underlying mechanism.
Totally 64 SAP patients were included in our study and randomly assigned into PCD+PD group (the combination group, N.=32) and convention group (N.=32). SAP patients in the combination group were treated with percutaneous catheter drainage combined with peritoneal dialysis, while those in the convention group were treated with conventional method. The treatment efficacy of both methods were evaluated by comparing levels of plasma inflammatory cytokines (IL-6, IL-8, TNF-α, C-reactive protein, procalcitonin and leukocyte count), relative indexes of important organs (aspartate aminotransferase, alanine aminotransferase, creatinine and urea nitrogen) and other clinical data (amelioration time of abdominal pain and abdominal distension, Balthazar CT scores, acute physiology and chronic health enquiry II score, length of hospital stay, complications and prognosis).
The expression levels of inflammatory cytokines were significantly decreased in the combination group in a time-dependent manner in comparison with those of the convention group. In addition, the amelioration time of abdominal pain and abdominal distension, length of hospital stay, Balthazar CT scores and the acute physiology and chronic health care II scores in the combination group were also significantly decreased in comparison with those of the convention group.
The combination treatment of PCD and PD effectively relieves the clinical symptoms of SAP by clearing plasma inflammatory cytokines.
探讨经皮导管引流（PCD）和腹膜透析（PD）治疗重症急性胰腺炎（SAP）的疗效及其潜在机制。
本研究共纳入64例SAP患者，随机分为PCD+PD组（联合组，n=32）和常规组（n=32）。联合组患者采用经皮导管引流联合腹膜透析治疗，常规组患者采用常规方法治疗。通过比较血浆炎症细胞因子（IL-6、IL-8、TNF-α、C反应蛋白、降钙素原和白细胞计数）水平、重要器官相关指标（天冬氨酸转氨酶、丙氨酸转氨酶、肌酐和尿素氮）以及其他临床数据（腹痛和腹胀缓解时间、Balthazar CT评分、急性生理与慢性健康状况评分II、住院时间、并发症和预后）来评估两种方法的治疗效果。
与常规组相比，联合组炎症细胞因子的表达水平随时间显著降低。此外，联合组的腹痛和腹胀缓解时间、住院时间、Balthazar CT评分以及急性生理与慢性健康护理II评分也显著低于常规组。
PCD与PD联合治疗通过清除血浆炎症细胞因子有效缓解了SAP的临床症状。
