Abstract: 【Abstract】〓Objective〓To observe the therapeutic effect of early blood purification combined with early selective digestive tract decontamination (SDD) on treatment of severe acute pancreatitis. Methods〓A retrospective analysis was performed in the 39 SAP patients admitted to Dongguan People’s Hospital from March 2012 to March 2015. The patients were divided into intervention group (n=21) and control group (n=19). The patients of intervention group were treated with early blood purification combined with early SDD, and the controls received conventional treatment. Clinical outcomes of post-treatment were assessed, including the time of bladder pressure below 15 mmHg, the time of vasoactive drugs, the duration of mechanical ventilation, the days of ICU admission, the average hospitalization expenses and inhospital mortality. Results〓Compare to control group, the time of bladder pressure below 15 mmHg was decreased in the intervention group (6±0.9 d vs 9±1.8 d, P<0.05), meanwhile, the time of vasoactive drugs and ICU admission were significantly reduced, but there was not significantly difference between two groups in the duration of mechanical ventilation. There was significantly difference between two groups on the average hospitalization expenses (intervention group: 22±4.8, control group: 31±7.3, P<0.05). The inhospital mortality of intervention group was 9.5%, and 22.2% in control group. Conclusion〓Early blood purification combined with SDD can improve clinical symptoms, shorten ICU admission, and decrease mortality of SAP patients.

Key words: Critically ill patient, Blood Purition, SDD

摘要： 【摘要】〓目的〓观察早期血液净化联合早期选择性肠道去污治疗重症急性胰腺炎的疗效。方法〓回顾性分析2012年3月至2015年3月份入住ICU的39例重症急性胰腺炎患者的临床资料,按胰腺炎的干预措施分为干预组和对照组,在胰腺炎其他基础治疗的前提下,干预组为严格执行早期血液净化联合肠道去污治疗的病例,对照组为未早期执行血液净化和/或肠道去污治疗的SAP患者,比较两组患者治疗后膀胱压降至15 mmHg以下的时间、血管活性药物使用时间、呼吸机使用时间、ICU住院时间、平均住院费用、住院病死率等临床预后指标。结果〓与对照组比较,干预组患者患者膀胱压降至15 mmHg以下的天数明显下降(6±0.9 VS 8±1.8天,P<0.05),血管活性药物使用时间明显缩短,但使用呼吸机时间无明显差异,干预组比对照组患者ICU住院时间明显缩短(15±3.2 VS 23±4.6天,P<0.05),干预组的平均住院花费也明显降低(22±4.8 VS 31±7.3万元,P<0.05)。最终,干预组住院病死率为9.5%,治疗组为22.2%,两组比较差异有显著性。结论〓早期血液净化联合早期肠道去污治疗重症急性胰腺炎,能明显减轻患者的临床症状,改善预后。

关键词: 急性胰腺炎, 血液净化, 肠道去污