在线制备置换液治疗重症胰腺炎的临床研究

Clinical Study of the Effects of Replacement Fluids Produced from On-Line Hemodiafiltration Facility in Continuous Blood Purification(CBP) of Severe Acute Pancreatitis(SAP)

目的观察联机在线制备(On-Line)置换液在重症胰腺炎患者连续性血液净化应用效果。方法选择肾内科行连续性血液净化治疗重症胰腺炎(SAP)患者35例,随机分成两组。观察组16例予On-Line置换液行连续性血液净化(CBP)治疗;对照组19例予经典Port配方置换液行CBP治疗。行不同置换液血液滤过过程前后,留取标本检查肾功能、电解质、淀粉酶等指标。及行急性生理和慢性健康评估(acute physiology and chronic health evaluation)APACHEⅡ评分。结果两组置换液配制后均无沉淀物形成,其内毒素检测均未超标。35例患者中26例好转出院,5例死亡,4例由于经济原因放弃治疗。两组患者治疗前后酸碱失衡得到纠正,尿素氮及肌酐明显下降,淀粉酶下降(组内比较差异有统计学意义,P<0.05)。两组患者治疗后APACHEⅡ评分下降(组内比较差异有统计学意义,P<0.05)。两组间比较差异无统计学意义(P>0.05)。结论联机在线制备(On-Line)置换液和经典Port配方置换液配制置换液在重症胰腺炎患者连续性血液净化应用均是安全有效的。On-Line置换液制备方便,成本低等优点值得推广使用。

Objective To investigate the effects of replacement fluids produced from on-line hemodiafiltration facility in continuous blood purification（CBP）of severe acute pancreatitis（SAP）.Methods 35 severe acute pancreatitis patients were randomly divided into two groups：16 patients were treated with the replacement fluids produced from on-line hemodiafiltration facility in continuous blood purification;19 patients were treated with the replacement fluids produced from Port,s composition in continuous blood purification;The patients,s electrolytes and serum amylase and blood urea nitrogen and serum creatinine and APACHEⅡ score were measured before and after treatments.Results The replacement fluids had not sediment,and their endotoxins didn＇t exceed standard.26 patients survived,5 patients died;4 patients gave up therapy.The two groups patients,s acidosis was corrected,their blood urea nitrogen and serum creatinine and amylase and the APACHEII score decreased（P〈0.05）.There had not differences statistically in comparison between two groups（P〉0.05）.Conclusion The replacement fluids produced from on-line hemodiafiltration facility and the replacement fluids produced from Port,s compositio in continuous blood purification of severe acute pancreatitis were safe and effective.The preparation of replacement fluids produced from on-line hemodiafiltration facility was facility and cheap.It was worth promoting.