早期CVVH治疗重症急性胰腺炎的临床疗效

Clinical Efficacy of Early CVVH for the Treatment of Severe Acute Pancreatitis

【目的】探讨早期行连续性静脉一静脉血液滤过（CVVH）对重症急性胰腺炎（SAP）的临床疗效。【方法】对2007年6月至2012年10月间19例行CVVH治疗的SAP患者（观察组）的临床资料进行回顾性分析，并与选择同期未行CVVH治疗的26例SAP（对照组）的临床疗效进行比较。【结果ICVVH观察组较对照组并发多器官功能障碍综合征（MODs）的几率显著降低（P〈0．01）。观察组心率、呼吸和外周血白细胞治疗后48h，与对照组比较差异有显著性（P〈0．05）。治疗后观察组APACHEⅡ评分、C反应蛋白、BalthazarCT评分优于对照组，且差异有显著性（P〈0．05）。【结论】在sAP早期CVVH治疗可以明显缓解急性反应期的临床症状，对组织器官的损害起到较好的保护作用，提高非手术治愈率。

[Objective] To explore the clinical efficacy of early continuous veno-venous hemofiltration（CVVH） for the treatment of severe acute panereatitis（SAP）. [Methods] Clinical data of 19 SAP patients receiving CVVH treatment in our hospital from June 2007 to Oct. 2012 were analyzed retrospectively, and compared with concur- rent 26 patients who did not receive CVVH treatment. [Results] Compared with control group, the incidence of MODS in CVVH treatment group decreased significantly（ P d0.01）. There were significant differences in heart rate, respiration and peripheral blood leukocytes 28h after treatment between two groups（ P d0.05）. APACHE ]~ , C-reactive protein and BalthazarCT score in CVVH treatment group were better than those in control group, and there were significant differences（ P d0.05）. [ConclusionlCVVH in the early treatment of SAP can obvious- ly alleviate the clinical symptoms of acute phase response, and play a better role in the protection of the damage to the tissues and organs, and improve the non-surgical cure rate.