连续性静脉-静脉血液滤过技术在重症急性胰腺炎治疗中的应用

Effectiveness of continuous venovenos hemofiltration on severe acute pancreatitis

目的观察联合连续性静脉-静脉血液滤过技术(CVVH)和内科常规治疗用于重症急性胰腺炎(SAP)的临床疗效。方法 30例SAP患者在接受内科常规治疗的同时给予连续性静脉-静脉血液滤过(CVVH)3 d,观察治疗前和治疗3 d后的患者症状,进行APACHEⅡ评分,检测血肌酐、血淀粉酶、C反应蛋白(CRP)的变化情况。结果治疗3 d后患者发热、心动过速、呼吸窘迫、腹痛、腹胀等症状明显缓解,APACHEⅡ评分改善,血肌酐、血淀粉酶、C反应蛋白水平均明显低于治疗前(P<0.01)。结论在非手术常规治疗的基础上早期联合CVVH治疗SAP,能有效缓解病情,保护器官功能,降低病死率,其明显的临床效果可能与清除体内炎症介质有关。

Objective To observe the clinical effects of continuous venovenos hemofiltration（CVVH）with general medical therapies for severe acute pancreatitis（SAP）.Methods 30 patients with severe acute pancreatitis ac-cepted CVVH for 3 days on the basis of general medical therapies.Observed the symptom of pre-treatment and after 3-days therapies,then got the scores of acute physiology and chronic health evaluation Ⅱ.Detected the variation of Scr,serum amylase,C-reactive protein.Results After 3 days treatment,symptoms of febrile,tachycardia,respirato-ry distress,abdominalgia and abdominal distention relieve obviously.The scores of acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ）decreased.The level of Scr,serum amylase and C-reactive protein descended sig-nificantly（P0.01）.Conclusion Combined with CVVH early on the basis of non-operative general medical thera-pies for SAP may effectively relieve the disease,protect the function of organs,decrease the mortality of SAP,and the mechanism may be related to the remove of mediators of inflammation.