Clinical effect of hemoperfusion combined with hemofiltration in acute pancreatitis associated with acute organophosphorus pesticide poisoning

doi:10.3877/cma.j.issn.2095-9133.2018.02.003

Abstract

Abstract:

Objective

To investigate the role of hemoperfusion combined with continuous veno-venous hemofiltration (CVVH) in the treatment of acute organophosphorus pesticide poisoning (AOPP) complicated with acute pancreatitis.

Methods

Forty-five AOPP-induced AP patients were randomly divided into blood purification group (n=23) and conventional group (n=22). The changes of white blood cell count (WBC), neutrophil count (NEUT) and procalcitonin (PCT) before treatment and 24, 48, 72 h after admission were observed in two groups of patients. Choline Esterase (AchE), serum amylase (AMY) return to normal time, per capita atropine consumption and the days of patients living in the ICU were compared.

Results

There were no significant differences in WBC, NEUT and PCT between the two groups before treatment (P>0.05). The white blood cell count (WBC) of patients in the blood purification group was lower than that of the conventional group at the time of 24 h, 48 h and 72 h [(13.45±2.37)×10^9 vs (15.72±1.83)×10^9, (11.5±1.5)×10^9 vs(14.12±1.74)×10^9, (9.06±1.42)×10^9 vs (11.82±1.86)×10^9, all P<0.05); The number of neutrophils (NEUT) in the blood purification group was significantly lower at 48h and 72h than those in the conventional group [(6.56±0.82)×10^9 vs (8.78±0.96)×10^9 and (5.37±0.34) ×10^9 vs (8.64±0.93)×10^9, all P<0.05); In the blood purification group, the procalcitonin (PCT) was lower at 48h and 72 h than that in the conventional group [(0.56±0.12)×10^9 vs (0.88±0.28)×10^9 and (0.37±0.06)×10^9 vs (0.59± 0.11)×10^9, all P <0.05 ]; The serum cholinesterase recovery time, amylase recovery time, per capita atropine consumption and patients' ICU time in the blood purification group were significantly less than those in the conventional group [(6.55 ± 1.15) d vs (11.35±2.05) d; 3.75±1.34 d vs 5.07±1.38 d and 225.18±57.24 mg vs 457.35±87.56 mg and 4.15±0.55 d vs 5.43±0.35 d, all P<0.05].

Conclusion

Hemoperfusion combined with continuous veno-venous hemofiltration can reduce the inflammatory response and the amount of atropine, shorten the hospital stay. It is worth in the treatment of the acute organophosphorus pesticide poisoning complicated by acute pancreatitis.

Key words: Hemoperfusion, Continuous veno-venous hemofiltration, Acute organophosphorus pesticide poisoning, Acute pancreatitis

Xianbao Zou, Binglei Xu, Baoquan Sun, Zhongkai Yu, Zhenzhen Wang, Yanmin Zhang, Aijun Qu. Clinical effect of hemoperfusion combined with hemofiltration in acute pancreatitis associated with acute organophosphorus pesticide poisoning[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2018, 04(02): 76-80.

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References 17

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组别	例数(例)	WBC(×10⁹)
组别	例数(例)	入院时	24 h	48 h	72 h
血液净化组	23	18.43±3.12	13.45±2.37^a	11.57±1.53^a	9.06±1.42^a
常规治疗组	22	17.72±2.05	15.72±1.83	14.12±1.74	11.82±1.86
t值	?	0.26	10.12	12.42	11.25
P值	?	>0.05	<0.05	<0.05	<0.05
组别	例数(例)	NEUT
组别	例数(例)	入院时	24 h	48 h	72 h
血液净化组	23	9.35±1.12	8.45±1.03	6.56±0.82^a	5.37±0.34^a
常规治疗组	22	9.72±1.15	8.98±1.11	8.78±0.96	8.64±0.93
t值	?	0.21	0.32	6.34	5.83
P值	?	>0.05	>0.05	<0.05	<0.05
组别	例数(例)	PCT(ng/mL)
组别	例数(例)	入院时	24 h	48 h	72 h
血液净化组	23	1.87±0.52	0.97±0.32	0.56±0.12^a	0.37±0.06^a
常规治疗组	22	1.92±0.48	0.98±0.33	0.88±0.28	0.59±0.11
t值	?	0.34	0.28	10.46	7.68
P值	?	>0.05	>0.05	<0.05	<0.05

组别	例数(例)	WBC(×10⁹)
组别	例数(例)	入院时	24 h	48 h	72 h
血液净化组	23	18.43±3.12	13.45±2.37^a	11.57±1.53^a	9.06±1.42^a
常规治疗组	22	17.72±2.05	15.72±1.83	14.12±1.74	11.82±1.86
t值	?	0.26	10.12	12.42	11.25
P值	?	>0.05	<0.05	<0.05	<0.05
组别	例数(例)	NEUT
组别	例数(例)	入院时	24 h	48 h	72 h
血液净化组	23	9.35±1.12	8.45±1.03	6.56±0.82^a	5.37±0.34^a
常规治疗组	22	9.72±1.15	8.98±1.11	8.78±0.96	8.64±0.93
t值	?	0.21	0.32	6.34	5.83
P值	?	>0.05	>0.05	<0.05	<0.05
组别	例数(例)	PCT(ng/mL)
组别	例数(例)	入院时	24 h	48 h	72 h
血液净化组	23	1.87±0.52	0.97±0.32	0.56±0.12^a	0.37±0.06^a
常规治疗组	22	1.92±0.48	0.98±0.33	0.88±0.28	0.59±0.11
t值	?	0.34	0.28	10.46	7.68
P值	?	>0.05	>0.05	<0.05	<0.05

组别	例数(例)	AMY恢复正常时间(d)	AchE恢复正常时间(d)	阿托品人均用量(mg)	ICU住院时间(d)
血液净化组	23	3.75±1.34^a	6.55±1.15^a	225.18±57.24^a	4.15±0.55^a
常规治疗组	22	5.07±1.38	11.35±2.05	457.35±87.56	5.43±0.35
t值	?	13.28	8.32	10.24	5.16
P值	?	<0.05	<0.05	<0.05	<0.05

组别	例数(例)	AMY恢复正常时间(d)	AchE恢复正常时间(d)	阿托品人均用量(mg)	ICU住院时间(d)
血液净化组	23	3.75±1.34^a	6.55±1.15^a	225.18±57.24^a	4.15±0.55^a
常规治疗组	22	5.07±1.38	11.35±2.05	457.35±87.56	5.43±0.35
t值	?	13.28	8.32	10.24	5.16
P值	?	<0.05	<0.05	<0.05	<0.05

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