血液滤过对重症急性胰腺炎的疗效观察

Effect of hemofiltration on severe acute pancreatitis

目的观察血液滤过（HF）对重症急性胰腺炎（SAP）的治疗效果。方法回顾性分析60例SAP在96h内各时间点上的生命指征、相关生化指标及最终转归，其中30例（APACHEⅡ评分为16．64±4．21）在传统常规治疗的基础上接受HF治疗，另30例（APACHEⅡ评分为15．05±3．78）按传统方法治疗。结果从开始接受治疗到治疗后96h内，各相同时间点比较，接受HF的患者体温、呼吸频率、心率、血常规、电解质、动脉血氧分压、肝功能及肾功能相关生化指标及腹痛腹胀等自觉症状，均较传统治疗组改善明显。总体住院时间与入院时已发病时间呈正相关，接受HF治疗组的住院时间较传统治疗组短。HF治疗组的死亡率（16．7％）与传统治疗组（30％）相比，差别并无显著性。结论HF对SAP患者的体温、呼吸频率、心率、血常规、电解质、肝功能、肾功能、肺功能、腹胀及腹痛等自觉症状均有明显的改善作用，能缩短患者住院时间，对SAP的治疗有积极意义。HF对患者的死亡率无明显改变作用。

Objective To investigate the therapeutic effect of hemofihration （HF） on severe acute pan- creatitis （SAP）. Methods The data of 60 patients with SAP was retrospectively reviewed in terms of life vital signs, biochemical indexes and prognosis within 96 h. 30 cases （ the average APACHE Ⅱ score was 16.64 ± 4.21 ） underwent HF on the basis of traditional treatment while another 30 cases （ the average APACHE Ⅱ score was 15.05 ± 3.78） were treated traditionally. Results From the beginning to 96 h after treatment, vital signs and the biochemical indexes such as body temperature, respiration rate, heart rate, blood electrolytes, blood pressure, liver function and renal function were improved more obviously in patients who received HF treatment than those who only received traditional treatment. The hospitalization time was positively correlated with the disease onset time. Patients receiving HF treatment need shorter hospitalization time than patients receiving conventional treatment. There was no significant difference in terms of mortality rate between HF treatment group and conventional treatment group （ 16.7% and 30% respectively）. Conclusions HF treatment can improve some biochemical indexes and symptoms in SAP patients. For example, body temperature, respiration rate, heart rate, blood electrolytes, liver function, kidney function, lung function, abdominal pain and abdominal distension. It can shorten hospitalization time. However, HF has no significant effect on mortality rate.