Observation on Efficacy of Continuous Blood Purification in the Treatment of Severe Acute Pancreatitis of 22 Cases

Objective:To study the treatment effect of continuous blood purification (CBP)on patients with severe acute pancreatitis (SAP). Methods: From June 2005 to December 2007,the continuous blood purification was performed in 22 patients(16 male,6 female and mean age 35.8 years)with severe acute pancreatitis . The CBP was performed continuously for 3 to 10 days. The filter was replaced between 24 and 48 hours. The ultrafiltration rate during CBP was 3 000 ~ 6 000 ml/h and blood flowrate was 200 ～300 ml/min. Normal heparin was used as anticoagulant. Results: Among 22 patients,18 patients relieved and 2 patients died from severe pulmonary infection with multiple organ failure,the else 2 patients had given up treatment. There were remarkable improvement in mean arterial blood pressure,heart rate and oxygenation index(P 0.05). The serumamylase[(87.59 ±31.68)U/L vs pre-treatment(638.65 ±79.42)U/L],lipase[(190.21 ±66.50)U/L vs pre-treatment(734.79 ±86.91)U/L],lactic acid [(1.69 ±0.82)mmol/L vs pre-treatment (7.11 ±3.25)mmol/L] and C-reactive protein [(39.33 ±10.17)mg/L vs pretreatment(141.21 ±33.63)mg/L]were also declined (P 0.05). The scores of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)were declined,too (P 0.05). Conclusion: The haemodynamic variables are stabilized during CBP and no obvious side-effects related to CBP is found. The therapy of continuous blood purification can improve the prognosis of the patients with severe acute pancreatitis.