Objective To explore the efficacy of early continuous renal replacement therapy(CRRT)combined with dexamethasone in the treatment of patients with severe acute pancreatitis(SAP)and acute respiratory distress syndrome(ARDS).Methods Clinical data of 62 patients with severe acute pancreatitis(SAP)and acute respiratory distress syndrome(ARDS)was retrospectively analyzed.The patients were divided into a control group of 31 cases and an observation group of 31 cases according to different treatment methods.Apart from mechanical ventilation,anti-infection and other conventional treatments,the control group received CRRT treatment,whereas the observation group received CRRT combined with dexamethasone treatments.Clinical indicators(time for disappearance of blood amylase,time for recovery of urine amylase,time for improvement of pancreatic edema,time for relief of abdominal pain,and length of hospital stay)after treatment,arterial oxygen partial pressure,oxygenation index,inflammatory factor indicators(interleukin-6,hypersensitive C-reactive protein,and tumor necrosis factor alpha),and disease-related scores(systemic inflammatory response syndrome score,acute physiological and chronic health scores)before and after 7 days of treatment were compared between the 2 groups of patients.Results After treatment,time for disappearance of blood amylase,time for recovery of urine amylase,time for improvement of pancreatic edema,time for relief of abdominal pain,and length of hospital stay were shorter in the observation group than those in the control group(all P＜0.001).After 7 days of treatment,arterial oxygen partial pressure and oxygenation index in the observation group were higher than those in the control group(all P＜0.001);the average levels of interleukin-6,hypersensitive C-reactive protein,and tumor necrosis factor alpha in the observation group were lower than those in the control group(P＜0.001 or P＜0.01);the systemic inflammatory response syndrome score,acute physiological and chronic health scores in the observation group were lower than those in the control group(P＜0.001,P＜0.05).Conclusions CRRT combined with dexamethasone can potentially improve the inflammatory status and blood gas function,accelerate the improvement of the condition,and facilitate prognosis recovery in SAP patients with ARDS.
acute severe pancreatitisacute respiratory distress syndromecontinuous renal replacement therapydexamethasoneinflammatory reactions
万方数据
维普
