Simple peritoneal lavage combined with venous-venous hemofiltration for severe acute pancreatitis

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Author:
DONG Tao(Department of Gastroenterology, Qingzhou Hospital, Weifang Medical College, Weifang 262500,China)
LUAN Chun-yan(Department of Gastroenterology, Qingzhou Hospital, Weifang Medical College, Weifang 262500,China)
JIN Wei(Department of Gastroenterology, Qingzhou Hospital, Weifang Medical College, Weifang 262500,China)
XU Jian-min(Department of Gastroenterology, Qingzhou Hospital, Weifang Medical College, Weifang 262500,China)
ZHANG Yin-hua(Department of Gastroenterology, Qingzhou Hospital, Weifang Medical College, Weifang 262500,China)
ZHAO Cun-xin(Department of Gastroenterology, Qingzhou Hospital, Weifang Medical College, Weifang 262500,China)
Journal Title:
CHINESE JOURNAL OF PANCREATOLOGY
Issue:
Volume 11, Issue 01, 2011
DOI:
10.3760/cma.j.issn.1674-1935.2011.01.004
Key Word:
Pancreatitis,acute necrotizing;Peritoneal lavage;Venous-venous hemofiltration

Abstract: Objective To investigate the effectiveness of simple peritoneal lavage combined with venous-venous hemofiltration therapy for severe acute pancreatitis (SAP). Methods Needles were inserted into abdominal cavity and tee was connected, then normal saline was administrated and discharged, followed by lidocaine, dexamethasone and antibiotics once daily until bloody peritoneal drainage became clear. At the same time venous-venous hemofiltration was used. Results 61 SAP patients were randomly divided into peritoneal lavage + hemofiltration group (treatment group, n =31) and control group (n = 31). The time to abdominal pain relief, abdominal distention relief, nausea and vomiting disappearance, peritoneal irritation disappearance was (1.5 ±0.3)d,(2.7 ±0.3)d, (1.9 ±0.3)d, (1.5 ±0.2)d, and the time to cure was (11.0 ±2.0)d in the treatment group, which was significantly shorter than that in the control group [(3.9 ± 0. 3) d, (4.5 ±0.6)d, (3.7 ±0.2)d, (5.3 ±0.4)d, (18.0 ±2.5)d, P<0.05]. At the 1st day of treatment, serum ALT,AST was significantly lower than that in the control group; at the 3rd day of treatment, the serum and urine amylase and serum levels of TNF-α, IL-6 and IL-8 level were significantly lower, but the serum level of IL-10,HCO3-was significantly higher than that in the control group (P < 0.05 or < 0. 01); at the 5th day of treatment, the serum Bun and Cr level were significantly lower than those in the control group (P < 0. 05).Conclusions Simple peritoneal lavage combined with venous-venous hemofiltration therapy can effectively eliminate the inflammatory factors, which is more rational and effective for the treatment of severe acute pancreatitis.

  • [1]中华医学会消化病学分会胰腺病学组.中国急性胰腺炎诊治指南(草案).胰腺病学,2004,4:35-38.
  • [2]张文俊,李兆申,许国铭,等.短期腹腔灌洗对重症急性胰腺炎的治疗价值.胃肠病学,2004,9:344-346.
  • [3]曹彤.腹膜透析治疗重症急性胰腺炎疗效分析.中国误诊学杂志.2009.9:91-92.
  • [4]Yekebas EF,Treede H,Knoefel WT,et al.Influence of zerobalanced hemofilitration on the course of severe experimental pancreatitis in pigs.Ann Surg,1999,229:514-522.
  • [5]周力,张祖隆,查艳,等.血液滤过治疗对重症急性胰腺炎血清细胞因子的影响.贵阳医学院学报,2005,30:245-246.
  • [6]梁朱岳.早期使用地塞米松对重症胰腺炎的治疗作用.中国急救医学,2001.21:726.
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