血液滤过在急性重症胰腺炎治疗中的应用

Application of Blood Filteration in Treatment of Severe Acute Pancreatitis

目的探讨连续性静脉-静脉血液滤过(CVVH)在重症急性胰腺炎(SAP)治疗中的应用。方法回顾性分析25例SAP患者,采用常规综合治疗的同时行CVVH,观察临床症状、治疗前后APACHEII评分及血生化指标的变化。结果CVVH治疗过程中,25例SAP患者呼吸窘迫、烦躁、谵妄、腹痛、腹胀等症状逐渐缓解;与治疗前比较,治疗后APACHEII评分差异有显著性(P<0.05);25例SAP患者经CVVH治疗24h后,血总胆红素(TB)、AST、AMS、APS均明显降低,与治疗前比较差异具有显著性(P<0.05)。结论SAP患者早期及时、有效行CVVH等综合治疗,能有效缓解临床症状、改善生化指标、有助于维持水、电解质、酸碱平衡、内环境以及微循环稳定、改善心、肺、肾功能,是安全、有效的治疗措施之一。

Objective To discuss the application of continuous vein-vein blood filteration（CVVH） in treatment of severe acute pancreatitis （SAP）. Methods The data of 25 SAP patients were analyized retrospectively. CVVH was used based on conventional comprehensive therapy, clinical symptoms, APACHEII scores and the blood biochemistry index changes were observed. Results During the CVVH course of treatment, the symptoms of 25 SAP patients such asrespiratory distress, dysphoria, delirium, abdominal pain and abdominal distension alleviated gradually; Compared with before the treatment, the APACHEII scores after the treatment had significant difference（P〈O.OS）. Blood total bilirubin（TB）,AST, AMS and APS of 25 SAP patients obviously reduced after 24 hours treatment, there was significant difference compared with before the treatment（P〈0.05）. Conclusion Early, prompt, effective treatment of CVVH on SAP patients can alleviate the clinical symptoms effectively, improve biochemistry index, is helpful to maintain the stability of water, the electrolyte, the acid-base equilibrium and internal environment, improve the function of heart, lungs and kidney. It is safe and effective treatment measures.