Effect of continuous blood purification in treatment of patients with severe acute pancreatitis and multiple organ dysfunction syndrome

Objective To observe the effect of continuous blood purification( CBP) on serum inflammatory mediators in patients with severe acute pancreatitis( SAP) and multiple organ dysfunction syndrome( MODS). Methods Sixty- five SAP patients with MODS who were treated in General Hospital of Chengdu Command Area of Chinese PLA from April 2008 to December 2013 were enrolled and divided into two groups. The 33 patients in the control group received comprehensive internal medicine treatment,and the 32 patients in the treatment group received comprehensive internal medicine treatment and CBP. Changes in APACHE II score,MODS score,and the serum levels of tumor necrosis factor α( TNFα),C- reactive protein( CRP),interleukin 6( IL- 6),IL- 18,platelet- activating factor( PAF),and nitric oxide( NO) after treatment were observed. Independent- samples t test was applied for comparison of continuous data between the two groups,and paired t test was applied for before- after comparison within the same group; chi- squared test was applied for comparison of categorical data between the two groups. Results In both groups,APACHE II score,MODS score,and the serum levels of TNFα,CRP,IL- 6,IL- 18,PAF,and NO decreased significantly after treatment( all P < 0. 05),and the treatment group had significantly greater decreases in these values than the control group( all P < 0. 001); the survival rates in the treatment group and the control group were 90. 6%( 29 /32)and 78. 8%( 26 /33),respectively,with no significant difference between the two groups( χ2= 1. 749,P = 0. 186). Conclusion In SAP patients with MODS,CBP can effectively clear the serum inflammatory mediators to block systemic inflammatory response and improve organ function,and,therefore,it is an effective method to treat SAP.