Objective To explore the clinical effect of early contrast-enhanced ultrasound (CEUS)-guided interventional procedures on patients with severe acute pancreatitis (SAP).

Methods A prospective controlled study was conducted, including 80 SAP patients admitted to the First Affiliated Hospital of Bengbu Medical University from July 2021 to July 2024. The patients were divided into an observation group and a control group using a simple randomization method, with 40 patients in each group. The observation group underwent CEUS and tube placement drainage within 48 hours of admission, while the control group underwent CEUS and tube placement drainage after 48 hours of admission. The time for body temperature to return to normal, the time for abdominal pain to significantly improve, the time for abdominal distension to significantly improve, the time for nausea and vomiting symptoms to disappear, as well as the Acute Physiology and Chronic Health Evaluation-Ⅱ (APACHE-Ⅱ) score system and Bedside Index for Severity in Acute Pancreatitis (BISAP) score before and after one week of interventional treatment were compared between the two groups. Peripheral blood white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), heparin-binding protein (HBP), interleukin-6 (IL-6), and serum calcium (Ca) levels were measured and compared at admission, on the fourth day after CEUS-guided interventional procedures, and on the seventh day after CEUS-guided interventional procedures.

Results The time for body temperature to return to normal, the time for abdominal distension to significantly improve, and the time for abdominal pain to significantly improve in the observation group were significantly shorter than those in the control group (P ＜ 0.05 to P ＜ 0.01), but there was no significant difference in the time for nausea and vomiting symptoms to disappear between the two groups (P ＞ 0.05). After one week of treatment, both APACHE-Ⅱ and BISAP scores decreased in both groups (P ＜ 0.01), with a greater decrease in the observation group compared to the control group (P ＜ 0.05). The levels of inflammatory factors WBC, CRP, PCT, HBP, and IL-6 in serum decreased between admission and the fourth day after CEUS-guided interventional procedures, as well as between the fourth and seventh days after CEUS-guided interventional procedures (P ＜ 0.05 to P ＜ 0.01), while the level of Ca increased (P ＜ 0.05 and P ＜ 0.01); Further comparison of the changes revealed that the decrease or increase in serum inflammatory factors WBC, CRP, PCT, HBP, IL-6, and Ca from admission to the fourth day after CEUS-guided intervention was higher than that in the control group (P ＜ 0.05 to P ＜ 0.01). From the fourth to the seventh day after CEUS-guided intervention, the decrease in serum inflammatory factors WBC, PCT, HBP, and IL-6 was greater than that in the control group (P ＜ 0.05 to P ＜ 0.01). However, there was no significant difference in the decrease in CRP and the increase in Ca between the groups (P ＞ 0.05).

Conclusions Early application of CEUS-guided intervention can improve the clinical symptoms of SAP patients, reduce the levels of peripheral blood inflammatory factors WBC, PCT, HBP, and IL-6, alleviate the inflammatory response in SAP patients, and benefit patient prognosis.