| Objective: Blood purification is commonly used in the treatment of critically ill patients,and its role in the treatment of severe acute pancreatitis so far is obvious.However,there is some controversy as to whether hemoperfusion combined with continuous renal replacement therapy is more effective than the latter therapy alone.Different studies have even reached conflicting conclusions.Therefore,we observe whether there are significant differences in blood purification methods in the treatment of severe acute pancreatitis through clinical retrospective observation studies.Methods: To collect clinical data of severe acute pancreatitis in four general hospitals in Xining area from January 1,2018 to December 31,2020,and divide them into 2 groups according to the different treatment modes selected.Analyze basic data,including gender,age,and disease status.Result indicators were re-analyzed.The main indicator was 28-day mortality.Other indicators included neutrophil /lymphocyte,PCT,CRP,SCR,TBIL,Amy,lac and APACHE II score.Results: A total of 75 people were included in this research,of which 37 were included in the CRRT group,and the other 38 cases were classified into the HP+CRRT group.Through statistical analysis,we found that the 28 day mortality of CRRT group was 32.43%(12 / 37);HP + CRRT group: The 28-day mortality rate was10.53%(4/38 persons).In terms of mortality,the two groups have significantly different performances(P<0.05).Both parties can reduce related infection indicators including PCT and CRP,liver,kidney and pancreatic function indexes such as AMY,SCr and TBi L.Lac and APACHE II scores could evaluate organ perfusion and disease severity(P < 0.05).Lac,SCr and TBIL had no difference before treatment.After receiving two different treatments,the HP+CRRT group had a greater decrease at 3d and 7d after treatment(P<0.05).On the 3rd and 7th day after the intervention,the decrease in PCT was greater in the HP+CRRT group(P<0.05).The scores of CRP and AMY decreased in different treatments(P<0.05),but there was no difference in the decrease rate of different treatments(P>0.05).Prognosis prediction: Logistic regression analysis results show that with other variables unchanged,every increase of PCT by one unit increases the incidence of death by 0.058 times;each increase of APACHE II score by one unit increases the incidence of death by 0.293 times.Conclusion: CRRT and HP + CRRT can control the inflammatory storm in the body,reduce the inflammatory index and alleviate organ failure.Compared with HP+CRRT,the curative effect is better,so there are fewer deaths in 28 days.The28-day case fatality rate of patients is positively correlated with PCT and APACHE II scores. |
