连续性肾脏替代治疗对急性重症胰腺炎伴急性肾功能衰竭患者血糖的影响及意义

The Effect of Continuous Renal Replacement Therapy on the Blood Glucose Level of the Patients with Severe Acute Pancreatitis Complicated with A cute Renal Failure

目的观察连续性肾替代治疗对急性重症胰腺炎伴急性肾功能衰竭患者血糖的影响。方法收集我院2006年7月～2010年7月应用持续外源性胰岛素泵入辅助连续性肾替代治疗的16例急性重症胰腺炎伴急性肾功能衰竭患者治疗的病例资料,统计分析患者血糖数据变化。结果 16例急性重症胰腺炎伴急性肾功能衰竭患者治疗前血糖均较高,在连续性肾替代治疗开始后前4小时血糖无明显变化,4小时后血糖下降明显,10小时后血糖变化趋于稳定并接近正常值。结论在持续外源性胰岛素泵入的配合下,连续性肾替代治疗能有效的降低急性重症胰腺炎伴急性肾功能衰竭患者的血糖,并能将血糖稳定在接近正常值,对预防高血糖引起的急性重症胰腺炎伴急性肾功能衰竭病情恶化起到有效的控制作用。

Objective To observe the effect of continuous renal replacement therapy（CRRT） on the blood glucose level of the patients with severe acute pancreatitis complicated with acute renal failure.Methods The clinical data of 16 cases with severe acute pancreatitis complicated with acute renal failure receiving CRRT assisted with continuous exogenous pumping of insulin in my hospital from July,2006 to July,2010 were collected and their blood glucose changes were statistical analyzed.Results Before treatment,the blood glucose levels of the 16 cases were high;no obvious changes of blood glucose were found in the first 4 hours after CRRT started;from the 4th hour,their blood glucose levels kept dropping down obviously and from the 10th hour,their blood glucose level turned to be stable close to the normal value.Conclusions With the assistance of continuous exogenous pumping of insulin,CRRT can effectively decrease the blood glucose level of the patients with severe acute pancreatitis complicated with acute renal function and keep the blood glucose level stable close to the normal value,it is of good control in preventing the exacerbation of severe acute pancreatitis complicated with acute renal failure caused by high blood glucose.