血液透析滤过联合血浆置换治疗妊娠并重度高脂血症性胰腺炎效果观察

Effects of hemodiafiltration with hyperlipemia treatment on pregnancy complicated with hyperlipemia in severe acute pancreatitis patients

目的:观察血液透析滤过联合血浆置换治疗妊娠并重度高脂血症性胰腺炎的效果。方法:选择12例妊娠并重度高脂血症性胰腺炎患者,随机分为2组。A组(n=7)行传统的胰腺炎治疗,B组(n=5)同时行血液透析滤过联合血浆置换治疗,比较2组患者住院(透析)后48h急性生理和慢性健康评价指标Ⅱ(APACHEⅡ)评分、禁食时间、住院时间、血尿淀粉酶恢复正常时间及住院(透析)6d后血清肿瘤坏死因子α(TNFα)水平。结果:B组患者APACHEⅡ评分、禁食时间、住院时间、血尿淀粉酶恢复正常时间均小于A组(P均<0.05)。A、B2组治疗后血清TNFα水平较治疗前均降低(P均<0.05),且B组较A组下降明显(P<0.05)。结论:血液透析滤过联合血浆置换是治疗妊娠并重度高脂血症性胰腺炎较好的方法。

Aim ： To observe the effect of hemodiafiltration and hyperlipemia treatment for pregnancy complicated with hyperlipemia in severe acute pancreatitis （PHP） patients. Methods：A total of 12 patients with PHP were randomly divided into two groups, group B with 5 cases accepted hemodiafihration with plasmapheresis and traditional treatment, and group A with 7 cases accepted the traditional treatment. The acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ ） score, the time of patients without eatting, total days of hospitalization, changing of hemodiastase and urinary amylase, and the level of TNFα after six days therapy of two groups were compared. Results ： The score of APACHE Ⅱ , the time of patients without eatting, the days of hospitalization, and the total days of hyper-hemodiastase, hyper-urinary amylase in group B were significantly lower than those of group A （P 〈 0. 05 ）. The levels of TNFcL in two groups all decreased after therapy （P 〈 0. 05 ） , and the TNFα level after therapy in group B was lower than that in group A （P 〈 O. 05 ）. Conclusion： The hemodiafiltration with plasmapheresis treatment is the better way to pregnancy complicated with hyperlipemia in severe acute pancreatitis patients.