腹膜透析治疗急性重症胰腺炎的临床疗效观察

Peritoneal dialysis in the treatment of severe acute pancreatitis： Observation of Clinical Efficacy

目的观察腹膜透析技术对治疗急性重症胰腺炎的临床疗效。方法将61例急性重症胰腺炎患者随机分为治疗组（31例）和对照组（30例）。治疗组在常规保守治疗基础上使用腹膜透析，连续治疗3d；对照组仅常规保守治疗。比较两组的肠功能恢复时间和血、尿淀粉酶恢复正常时间以及旭～CHEⅡ积分。同时比较两组外周血肿瘤坏死因子（耵师）和白细胞介素-1（IL—1）、白细胞介素-6（IL-6）、白细胞介素-8（ILIL-8）、白细胞介素-10（IL-10）水平影响。在治疗前后各时相点的含量。结果治疗组肠功能恢复时间及血、尿淀粉酶恢复正常时间、APACHEⅡ积分降低数值与对照组比较有统计学意义（P〈0．05）。治疗组外周血耵晒和IL—1、IL-6、1L-8、IL-10在治疗后第-天、第二天与治疗前以及对照组比较有统计学意义（P〈0．05）。结论腹膜透析治疗急性重症胰腺炎临床疗效确切，对于清除炎症介质和阻止全身病情加重有显著临床价值，而且早期疗效更为明显。

Objective To observe the clinical efficacy of peritoneal dialysis（PD）in the treatrnent of severe acute pancre- atitis（SAP）. Methods Sixty- one patients with SAP were divided at random into the PD group（therapeutic group,31 patients） and the non- PD group（contrast group,30 patients）.Both groups were treated by the conventional mode of therapy.The recovery trine of intestinal function and serum amylase and uric amylase, APACHEⅡscores of the two groups were compared.Simultaneously,the concentration of serum IL- 1 ,IL- 6,IL- 8,IL- 10 and the concentration of serum TNF were also determined pro and post the therapy. Results The recovery time of intestinal function, serum amylase, uric amylase and APACHE Ⅱ scores were significantly decreased（ P 〈 0.05）compared with those of the contrast group.The difference between the TNF and IL- 1,IL- 6.IL- 8,IL- 10 detected at the end of 1 d,2 d after PD with those observed in pro PD and the contrast group was significant（ P 〈 0.05）. Conclusion The above results show that peritoneal dialysis（PD）is satisfactory in treating severe acute pancreatitis（SAP）. The cytokines overproduced during the development of SAP can be removed effectively from the fluid filtrated by means of PD. The continual deterioration of the local focus and systematic presentation could be prevented effectively too, and the earlier the treatment of PD, the better the prognosis.