静脉血液滤过治疗36例重症急性胰腺炎疗效观察

Observation of efficacy of venous hemofiltration in treatment of 36 patients with severe acute pancreatitis

目的探讨静脉血液滤过治疗重症急性胰腺炎的临床疗效,为临床提供最佳治疗的理论依据。方法选取2005年1月-2011年6月于医院进行治疗的72例重症急性胰腺炎患者为研究对象,将其随机分为对照组和观察组各36例,对照组采用常规治疗方案进行治疗,观察组在对照组基础上加用静脉血液滤过治疗方案进行治疗后,将两组患者的存活率、症状体征恢复时间及治疗前、治疗后血清淀粉酶、脂肪酶、C反应蛋白(CRP)、TNF-α水平进行比较。结果观察组的存活率为97.22%,症状体征恢复时间为发热(2.01±0.36)d、腹痛(4.18±0.96)d、淀粉酶(5.09±1.04)d,治疗后血清淀粉酶为(467.12±92.67)U/L,脂肪酶为(121.34±76.42)U/L,CRP为(5.37±1.85)mg/L,TNF-α为(224.12±53.97)ng/L,水平均优于对照组,差异均有统计学意义(P<0.05)。结论静脉血液滤过治疗重症急性胰腺炎的临床疗效较佳,且显效较快,可改善患者的炎性状态。

OBJECTIVE To investigate the clinical efficacy of venous hemofiltration in treatment of severe acute pancreatiti so as to provide theoretical basis for the best clinical treatment. METHODS A total of 72 patients with severe acute pancreatitis who enrolled the hospital from Jan 2005 to Jun 2011 were chosen as the research objects. They were randomly divided into the control group with 36 patients and the observation group with 36 patients. The control group was taken with the conventional treatment program, and the observation group was treated with the venous hemofiltration based on the control group. The survival rate, recovery time of symptoms and signs, and the levels of serum amylase, lipase, CRP, and TNF-α before and after the treatment between the two groups were compared. RESULTS In the observation group, the survival rate was 97. 22%, the recovery time of symptoms and signs ： fever （2.01±0.36） days, abdominal pain （4.18± 0.96） d days, and amylase （5.09 ±1.04） days ; after the treatment, the level of serum amylase was （ 467.12±92.67） U/L, lipase （121.34± 76.42） U/L, CRP （5.37 ±1.85） mg/L, and TNF-α （224.12± 53. 97） ng/L, all of which were higher than those of the control group, the differences were statistically significant （P〈0.05）. CONCLUSION The venous hemofiltration can achieve good clinical efficacy in the treatment of severe acute pancreatitis and rapidly improve the inflammatory state.