Abstract:

 [Abstract]   Objective   To observe the clinical efficacy of coupled plasma filtration adsorption (CPFA) combined
with high volume hemofiltration (HVHF) for severe acute pancreatitis (SAP) and explore the practicality, the safety and the therapeutic mechanism.  Methods  This was a prospective, randomized clinical trail. A total of29patients with SAP were divided into two groups: treatment group (n=15, CPFA and HVHF) and control group (n=14, HVHF). The APACHEⅡscore, serum triglyceride, liver and kidney function, white blood cell (WBC), heart rate (HR), respiration, mean arterial pressure (MAP) and oxygenation index were compared before and after treatment between two groups. The organ function was assessed, and the adverse reactions and prognosis were observed in two groups. Results   After treatment, there were significant decreases in APACHEⅡscore and WBC, and significant increase in PaO2/FiO2 in two groups, especially significant in treatment group. There was a significant decrease in the level of triglycerides in 7-d treatment group than that of3-d treatment group (P＜0.05). There were no thrombocytopenia, bleeding, allergies, blood clotting and other adverse reactions in two groups of patients. There were significant decreases in the blood purification time and the length of hospital stay in treatment group than those of control group (P＜0.05). There was no significant difference in mortality between two groups.   Conclusion   CPFA combined with HVHF can effectively control inflammation, reduce the serum level of triglyceride and improve the prognosis in patients with SAP.

Key words: Coupled plasma filtration adsorption, High volume hemofiltration, Severe acute pancreatitis