Choice criteria and efficiency of plazmapheresis application in treatment of acute destructive pancreatitis
Objectives. To work out the objective criteria of endogenous intoxication severity permitting to determine the indications and to evaluate the efficacy of plazmapheresis in the intensive therapy complex of the acute destructive pancreatitis in the enzymatic phase of the disease. Methods. Treatment results of 304 patients with the acute destructive pancreatitis were studied. The indicators of weight level of average molecules and leukocytes intoxication index were used as criteria of endogenous intoxication severity. Complex therapy of 166 patients (the basic group) included using of medical plazmapheresis, in 138 patients (the control group) plazmapheresis wasn't used during treatment. Plazmapheresis had serial character and was applied only in the enzymatic phase of the acute pancreatitis to stop early endogenous intoxications. Results. It is established that application of serial medical plazmapheresis in the basic group of patients in the early phase of pathological process reduces frequency of purulent complications, mortality from purulent complications and the general mortality. Conclusions. Plazmapheresis is highly effective, pathogenetically proved method of detoxication in cases of the acute destructive pancreatitis.