Abstract：Objective To investigate the efficacy of continuous blood purification combined with gabexate on serum soluble vascular endothelial growth factor receptor 1 （sFlt-1） and Visfatin in patients with severe acute pancreatitis. Methods A total of 120 severe acute pancreatitis patients who were treated in our hospital from August 2017 to March 2019 were selected and divided into a control group and an observation group according to the treatment method, with 60 cases in each group. The control group was given continuous blood purification treatment, and the observation group was given continuous blood purification combined with gabexate treatment. The clinical related indexes and total efficacy after treatment, serum inflammatory cytokine,  sFlt-1, Visfatin levels, and intestinal mucosal permeability and incidence of adverse reactions before and after treatment were compared between the two groups. Results After treatment, the length of hospitalization, duration of abdominal pain, defecation time, APACHE score and intra-abdominal pressure in the observation group were all better than those in the control group, and the differences between the two groups were statistically significant （t＝11.426, 3.511, 3.329, 11.138, 5.345, all P＜0.05）; the total effective rate of treatment was higher in the observation group than in the control group, and the differences between the two groups were statistically significant （χ2＝10.208, P＜0.05）; the serum inflammatory cytokines, sFlt-1, Visfatin, serum diamine oxidase, and lactose/mannitol ratios after treatment were all lower than before treatment in the observation group, and the reductions in the observation group were all better than those in the control group, and the differences between the two groups were statistically significant（t＝13.379, 15.080, 9.656, 4.307, 2.859, 3.498, 11.188, all P＜0.05）; the difference in the incidence of adverse reactions between the two groups was not statistically significant （χ2＝0.536, P＞0.05）.  Conclusion Continuous blood purification combined with gabexate has a better therapeutic effect on severe acute pancreatitis, which could effectively improve the clinical efficacy, reduce serum inflammatory cytokines, sFlt-1 and Visfatin levels, reduce inflammation, protect the intestinal mucosal barrier, and not increase adverse reactions.