Fluid resuscitation of severe acute pancreatitis with combining drug therapy        ZHANG Jian*, YANG Zheng-an, ZHANG Zheng-liang, et al.*Department of Cadres Ward-IV(General Surgery), the Second Affiliated Hospital of Medical School of Xi’an Jiaotong University, Xi’an 710004, China
Corresponding author: ZHANG Jian，E-mail: zhangjian-937@163.com
Abstract    Objective    To observe and evaluate the effect of VDF therapy (combining use of 6% hydroxyethyl starch 130 /0.4, Dexamethasone and Furosemide) on the severe acute pancreatitis (SAP) during fluid resuscitation stage. Methods    During January 2006 and May 2010, 47 consecutive cases of SAP were admitted. They were randomly assigned to VDF therapy group (26 cases) and control group(21 cases). Patients in VDF therapy group were administered with Voluven, Dexamethasone and Furosemide, while Ringer’s lactate was applied to the control group. Otherwise, the two group had the same therapeutic strategies.  Results VDF group remarkably improved the systemic inflammatory response after 72h admission, as compared with the control group ［△APACHEⅡscore (4.28±1.90) vs. (-1.00±2.87), P <0.01］. It had shorter time interval to reach the stable hemadynamic state ［（4.54±1.62）h vs. (7.99±1.66)h, P <0.01］ and total amount of fluid replacement within 72h after admission ［（10780±1856）mL vs. (13845±2477)mL, P <0.01］ than control group. The intestinal function recovered faster in VDF group than in control group ［(4.00±1.74)d vs. (5.26±1.92)d, P <0.05］. Compared with control group, VDF therapy significantly decreased the ACS （3.8% vs.28.6%, P <0.05）, time of hospital stay ［（20.12±10.37）d vs. (29.4±15.6)d, P <0.05］and mortality（3.8% vs. 23.8%, P <0.05）. Although there were no statistical differences in complications and transfer to operation in the two group（P >0.05）. Conclusion    Combined use of 6% hydroxyethyl starch 130 /0.4 (Voluven), Dexamethasone and Furosemide could improve the severity and prognosis of SAP fast and effectively and decrease the mortality of SAP significantly.