早期血滤联合腹腔穿刺置管冲洗负吸治疗重症急性胰腺炎的临床观察

The Effect of Early Continuous Renal Replacement Therapy Combining with Vacuum Aspiration Using Abdominal Puncture Catheter on Severe Acute Pancreatitis(SAP) Treatment

目的:探讨早期血液滤过联合腹腔穿刺置管冲洗负吸对重症急性胰腺炎(SAP)的临床疗效。方法:将40例符合SAP诊断标准患者随机分成治疗组(血液滤过联合腹腔穿刺置管冲洗负吸)和对照组(血液滤过+传统治疗),每组20例,检测两组急性生理与慢性健康评估评分(APACHE-Ⅱ评分)、腹腔高压持续时间、入ICU住院时间及中转手术率。结果:与对照组比较,治疗组腹腔高压持续时间及入ICU住院时间缩短,中转手术率下降,APACHE-Ⅱ评分下降(P<0.01或P<0.05)。结论:早期应用血液滤过联合腹腔穿刺置管冲洗负吸治疗重症急性胰腺炎取得较好疗效,缩短住院时间,节约患者费用,值得临床应用。

Objective： To observe and analyze the effect of early continuous renal replacement therapy combining with vacuum aspiration using abdominal puncture catheteron severe acute pancreatitis treatment. Method： 40 SAP patients were divided into treatment group and control group, each consisting of 20 patients.The treatment group were applied to early venovenous hemofiltresion combining with vacuum aspiration using abdominal puncture catheter. The control group were applied to early venovenous hemofiltresion combining with traditional therapy. Acute physiology and chronic health evaluation score-Ⅱ （APACHE-Ⅱ ）, duration of intra-abdominal hypertension, length of stay in ICU and the rates of surgical operation transfer after the therapy of both groups were recorded and analyzed. Result： Compared with the control group, the scores of APACHE-Ⅱ of the treatment group witnessed a decline and the duration of intra-abdominal hypertension, length of stay in ICU and rates of surgical operation transfer for the patients in the treatment group were shortened and reduced. Conclusion： Early continuous renal replacement therapy combining with vacuum aspiration using abdominal puncture catheter in severe acute pancreatitis（SAP） treatment can shorten the length of hospitalization and save costs for patients.