CRRT早期在重症急性胰腺炎患者中的临床应用

Clinical applications of early continuous renal replacement therapy in patients with severe acute pancreatitis

目的观察早期连续肾替代治疗(CRRT)对重症急性胰腺炎(SAP)预后的影响。方法将26例患者随机分为常规治疗组(13例)和治疗组(常规治疗+CRRT治疗,13例)。观察治疗前、治疗后6h、12h、24h、48h、72h各时间点抽取动脉血气分析,乳酸,C反应蛋白(CRP)的变化。治疗72h后2组治疗效果APACHEII评分进行比较。结果治疗后6h、12h、24h、48h、72h患者动脉血气分析明显改善,乳酸和CRP水平明显下降,差异均有统计学意义(P<0.05),治疗72h后,治疗组患者APACHEII评分(17.0±5.6 vs 12.8±3.5,P<0.05)较治疗前明显好转,而常规治疗组患者变化并不显著。结论早期治疗能快速有效改善患者病情,明显改善各脏器功能,值得临床推广应用。

Objective To observe the effect of early continuous renal replacement therapy （CRRT） on severe acute pan- creatitis （SAP）. Methods Twenty-six patients with SAP were randomly divided into routine treatment group （13 cases） and CRRT group （routine treatment ＋ CRRT, 13 cases）. At the time before CRRT and 6,12,24,48,72h after CRRT , the arterial blood was sampled for arterial blood gas analysis and kept for the determining the change of lactic acid and CRP level. The clinical efficacy（APACHEll score）were compared between 2 group 72 hours after treatment. Results Just at 6, 12,24,48,72h after CRRF, the patients＇ arterial pressure of oxygen and oxygen action index increased , CRP and lactic acid decreased sign inficantly （P 〈 0. 05 ）, APACHE II score （ 17.0 ± 5.6 vs 12. 8 ± 3.5 P 〈 0.05 ） were Significantly in patients with CRRT 72 hour alter treat- ment. Howerer, the improvement in patients of routine treatment group was not so obviously. Conclusion CRRT can not only effectively improve the prognosis of patients with SAP, but also significantly improve the function of various organs. It is worthy of clinical application.