Effect Of Continuous Renal Replacement Therapy Timing On The Recovery And Prognosis Of Severe Acute Pancreatitis

Objective: Continuous renal replacement therapy is one of the important supportive treatments for severe acute pancreatitis.This article mainly explores the impact of the timing of CRRT therapy on the recovery and prognosis of severe acute pancreatitis.Methods:A total of 60 CRRT-treated SAP patients admitted to our hospital from January 2014 to January 2018 were retrospectively analyzed and divided into group A(n = 31)and group B(n = 29).In group A,patients who started CRRT within 72 hours of onset had a mean onset of treatment of 53.03 ± 14.53 hours.Patients in group B started CRRT after 72 hours of onset with an average treatment time of 158.41 ± 93.70 hours.Analyze and compare APACHE ? score and some of its index,Pa O2 / Fi O2,remaining base BE,C-reactive protein CRP and modified Marshall score before treatment and 72 hours after the start of treatment.And Balthazar CT grade and modified MCTSI score in the first week of the two groups and the fourth week of the onset of the disease,local complications of pancreas in the fourth week after the onset of disease,and hospital stay in the two groups.Results:Comparisons of general information such as gender,age,and causes of the two groups of patients,as well as the vital signs and physical and chemical indexes before CRRT treatment between the two groups were performed.There was no significant difference between the two groups(P> 0.05).(1)After 72 hours of starting CRRT treatment in both groups,the indexes in group A were significantly improved compared with that before treatment,the difference was statistically significant(P <0.05).The oxygenation index and WBC in group B were not significantly improved compared with those before treatment(P> 0.05).The other indexes such as body temperature,respiratory rate,heart rate,MAP,p H,Hct,Cr,CRP,APACHE II score,Compared with before treatment,there was a significant improvement(P <0.05).(2)At 72 h after CRRT treatment in both groups,thetemperature,respiratory rate,oxygenation index,WBC,APACHE ? score index and modified Marshall score improved significantly in group A compared with those in group B(P <0.05)Heart rate,MAP,pH,Hct,Cr,CRP no significant difference(P> 0.05).(3)Balthazar CT grade and modified MCTSI score of the 4th week in group A were lower than those in group B(P <0.05).(4)4 week after the onset of disease,57.1%(12/21)of patients in group A had local complications of pancreas,of which 1 were pseudocyst and 11 was walled-off necrosis.In group B,85.7%(18/21)There were 3 cases of pseudocyst and 15 cases of walled-off necrosis with no significant difference(P> 0.05).(5)The hospital stay in group A was significantly lower than that in group B(P <0.05).Conclusion: Severe acute pancreatitis patients within 72 hours after onset of CRRT therapy applied more than 72 hours after onset,can be more significantly reduce the inflammatory response,improve organ function,improve prognosis and reduce hospital stay.