Selection Of Appropriate Period Of Blood Purification For Patients With Hyperlipidemic Pancreatitis

Objective To select the appropriate period of treatment for patients with hyperlipidemic pancreatitis based on conventional therapy with hemoperfusion and continuous veno-venous hemofiltration.Methods A retrospective study was performed on the clinical data of 49 hyperlipidemic pancreatitis patients between January 2011 and March 2014. All included patients were into 3 groups based on the time they start to receive the blood purification. Eleven patients in group A began blood purification treatment within 4 hours after disease onset.Group B containes 29 cases undergoing blood purification treatment between 72 hours and 120 hours. Six patients in group C underwent blood purification treatment after 120 hours. Acute physiology and chronic health Results After treatment, acute physiology and chronic health evaluation Ⅱ score, c-reactive protein, hematocrit, triglyceride, total cholesterol, serum creatinine, alanine aminotransferase, Pa O2/Fi O2 and average length of stay were observed and recorded before and after treatment.evaluation Ⅱ score, c-reactive protein, hematocrit, triglyceride, total cholesterol, serum creatinine, alanine aminotransferase of group A and group B were decreased, and Pa O2/Fi O2 of group A and group B were elevated; but there was no statistical significant difference in above indexes before and after treatment in group C(P >0.05). Acute physiology and chronic health evaluation Ⅱ score, c-reactive protein, serum creatinine,alanine aminotransferase, Pa O2/Fi O2 were changed more significantly in group B, while no difference in hematocrit, triglyceride and total cholesterol was observed between group A and group B(P>0.05)after treatment, which shows that undergoing hemoperfusion and continuous veno-venous hemofiltration in the early stage can effectively decrease blood lipid level and relief systemic inflammatory response. Peak period of systemic inflammatory response was between 4~72 hours. As to average length of stay, group B was the shortest.Conclusion Except the conventional is necessary to start hemoperfusion and continuous veno-venous hemofiltration treatment between 4~72 hours after disease onset for hyperlipidemic pancreatitis patients.