早期持续高容量血液滤过在重症急性胰腺炎治疗中的应用

Application of early continuous high-volume-hemofiltration in the treatment of severe acute pancreatitis

目的研究早期持续高容量血液滤过对重症急性胰腺炎(SAP)患者的临床疗效。方法选择27例SAP患者,在传统治疗方法的基础上,使用高容量血液滤过进行早期干预,比较血液滤过前后腹部症状、生命体征、血气分析、血清生化指标、APACHEⅡ评分变化。结果治疗后患者发热、心动过速、呼吸急促、腹痛、腹胀等症状明显缓解;血清谷丙转氨酶、总胆红素、肌酐、尿素氮均明显下降,氧合指数明显提高,APACHEⅡ评分改善,与治疗前比较有统计学差异(P<0.05)。结论早期持续高容量血液滤过治疗SAP能早期改善临床症状,减少并发症,改善脏器功能,降低病死率,可作为SAP早期重要的辅助治疗措施。

Objective To investigate the efficacy of early continuous high-volume-hemofiltration on patients with severe acute pancreatitis.Methods A total of 27 patients with severe acute pancreatitis were performed early continuous high-volume-hemofiltration and traditional therapies.The changes of vital signs、clinical symptoms and laboratory indicators were compared before and after the treatment.Results Compared with those before hemofiltration,the clinical symptoms such as fever,tachycardia,respiratory distress and abdominal pain were significantly remitted(all P<0.05).The APACHEⅡscore and the level of laboratory indicators such as TBIL,Cr,BUN,AST,ALT were decreased(all P<0.05).and the level of PaO2 /FiO2 was increased(P<0.05).Conclusion The early continuous high-volume-hemofiltration on patients with SAP can relieve clinical symptoms early,prevent the complications,protect the function of organs and decrease the mortality.It may become one of the most important auxiliary therapies in the early edge of the disease.