Department of Geriatric Medicine, Jiangyin Hospital Affiliated to Nantong University, Jiangyin, Jiangsu, China (mainland).
Department of Intensive Care Unit, Jiangyin Hospital Affiliated to Nantong University, Jiangyin, Jiangsu, China (mainland).
Med Sci Monit. 2023 Apr 12;29:e939314. doi: 10.12659/MSM.939314.
BACKGROUND We aimed to investigate the clinical efficacy of continuous renal replacement therapy (CRRT) in combination with peritoneal lavage for the treatment of severe acute pancreatitis. MATERIAL AND METHODS We retrospectively reviewed data from 52 patients with severe acute pancreatitis between January 2014 and December 2021 at Jiangyin People's Hospital. The patients were divided into 2 groups: CRRT (n=26) and CRRT in combination with peritoneal lavage (n=26). The following results and outcomes were retrospectively compared: procalcitonin, interleukin-6, and C-reactive protein levels, duration of systemic inflammatory response, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, abdominal distention relief time, abdominal pain relief time, length of intensive care unit stay, length of hospital stay, inpatient hospital costs, incidence of complications, and mortality. RESULTS There were significant differences in interleukin-6 and procalcitonin levels and APACHE-II scores after 3 and 7 days of treatment. The duration of systemic inflammatory response, abdominal distention relief time, abdominal pain relief time, length of intensive care unit stay, and length of hospital stay were considerably shorter in the combination group than in the CRRT group (P<0.01). Inpatient hospital costs were significantly lower in the combination group than in the CRRT group (P<0.01). However, incidence of complications and mortality showed no significant differences between the 2 groups. CONCLUSIONS CRRT combined with peritoneal lavage is an important adjuvant therapy in the early stages of acute severe acute pancreatitis and has better clinical efficacy than CRRT alone.
我们旨在探讨连续性肾脏替代疗法(CRRT)联合腹腔灌洗治疗重症急性胰腺炎的临床疗效。
我们回顾性分析了 2014 年 1 月至 2021 年 12 月间江阴市人民医院收治的 52 例重症急性胰腺炎患者的资料。患者分为两组:CRRT 组(n=26)和 CRRT 联合腹腔灌洗组(n=26)。回顾比较以下结果和结局:降钙素原、白细胞介素-6 和 C 反应蛋白水平、全身炎症反应持续时间、急性生理学与慢性健康状况评分系统 II(APACHE II)评分、腹胀缓解时间、腹痛缓解时间、重症监护病房住院时间、住院时间、住院费用、并发症发生率和死亡率。
治疗后 3 天和 7 天,白细胞介素-6 和降钙素原水平以及 APACHE-II 评分有显著差异。联合组全身炎症反应持续时间、腹胀缓解时间、腹痛缓解时间、重症监护病房住院时间和住院时间均明显短于 CRRT 组(P<0.01)。联合组住院费用明显低于 CRRT 组(P<0.01)。然而,两组并发症发生率和死亡率无显著差异。
CRRT 联合腹腔灌洗是重症急性胰腺炎早期的重要辅助治疗方法,其临床疗效优于单纯 CRRT。