Yadav Satish Chandra, Zhang Bingqiang
The First Affiliated Hospital Chongqing Medical University, China.
Gastroenterol Res Pract. 2022 Mar 7;2022:7575231. doi: 10.1155/2022/7575231. eCollection 2022.
To compare the conventional treatment and continuous veno-venous haemofiltration (CVVH) in severe acute pancreatitis (SAP) for the prevention of pseudocyst and walled-off necrosis. . Forty-two patients were divided into two treatment groups: conventional treatment group contained 24 patients and CVVH had 18. Conventional treatment group patients were treated symptomatically and according to the causes. CVVH group patients were treated symptomatically, and CVVH was done within 2 hours of admission.
In both groups, there was a decrease in amylase, lipase, CRP, IL-6, IL-10, TNF-alpha, Ranson score, Balthazar score, and APACHE-II score after 72 hours, but the decrease was significantly greater in CVVH patients. There were no any local pancreatic complications in CVVH patients, but 1 patient had an acute peripancreatic fluid collection, 2 patients had pseudocyst, and 2 patients had walled-off necrosis (WON), and a mortality one was seen in the conventional treatment group.
The present study shows that early CVVH may be able to prevent the formation of pseudocyst and win in SAP patients.
比较传统治疗与持续静脉-静脉血液滤过(CVVH)在重症急性胰腺炎(SAP)中预防假性囊肿和包裹性坏死的效果。42例患者分为两个治疗组:传统治疗组24例,CVVH组18例。传统治疗组患者根据病因进行对症治疗。CVVH组患者进行对症治疗,并在入院后2小时内进行CVVH。
两组患者在72小时后淀粉酶、脂肪酶、CRP、IL-6、IL-10、TNF-α、兰森评分、巴尔萨泽评分和APACHE-II评分均有所下降,但CVVH组患者的下降幅度明显更大。CVVH组患者未出现任何胰腺局部并发症,但传统治疗组有1例患者出现急性胰周液体积聚,2例患者出现假性囊肿,2例患者出现包裹性坏死(WON),且有1例死亡。
本研究表明,早期CVVH可能能够预防SAP患者假性囊肿的形成并取得良好效果。