连续性肾脏替代治疗应用于重症急性胰腺炎的临床疗效分析

Clinical effectiveness of continuous renal replacement therapy for severe acute pancreatitis

目的研究连续性肾脏替代治疗（CRRT）应用于重症急性胰腺炎（SAP）的临床疗效。方法2010年3月至2012年12月收治的58例SAP患者，分为2组，CRRT组（40例）患者入院后即在常规治疗的同时给予CRRT；常规治疗组（18例）患者则给予常规抗胰腺炎治疗。结果治疗3d后，APACHEII评分CRRT组优于常规治疗组（P〈0．01）；血生化指标中CRRT组氧合指数、血钙水平高于常规治疗组，而血肌酐水平、白细胞计数低于常规治疗组，差异有统计学意义（P〈0．05或P〈0．01）。CRRT组并发症发生率（6．2%）低于常规治疗组（13．7%），而治愈率（88．3％）高于常规治疗组（67．1％），差异有统计学意义（P〈0．05或P〈0．01）。结论SAP发病早期，无急诊手术指征的患者在常规治疗的基础上实施CRRT可有效缓解病情，减少并发症发生率，提高治愈率。

Objective To investigate the clinical effectiveness of the continuous renal replacement therapy （CRRT） for severe acute pancreatitis （SAP）. Methods Forty-eight patients with SAP between March 2010 and December 2012 were divided into two groups：CRRT group （n = 40） receiving CRRT besides routine treatments,and routine therapy group （n = 18） receiving routine treatments only. Results As compared with toutine therapy group,APATHE II scores in CRRT group were significantly decreased. There was significant difference in oxygenation index, serum calcium, serum creatine and white blood cells count between CRRT group and routine therapy group. The incidence of compli- cation in CRRT group （6. 2%） was significantly lower than that in routine therapy group （13.7%） （P 〈（0. 05 or P〈0. 01 ）, but the curative rate in CRRT group （88. 3 %） was significantly higher than that in routine therapy group （67. 1%） （P〈0. 05 or P〈0. 01）. Conclusion CRRT during the early period in SAP patients can reduce the incidence of complications and increase the curative rate.