高超滤率连续性肾脏替代疗法在重症胰腺炎治疗中的应用

Effect analysis of high filtration rate continuous renal replacement therapy in severe acute pancreatitis patients

目的探讨高超滤率连续性肾脏替代疗法(CRRT)在重症急性胰腺炎治疗中的应用。方法我院2010年4月至2013年3月收治56例重症急性胰腺炎患者,按入院时间将其分为观察组(26例)和对照组(30例),对照组使用CRRT进行血液净化,观察组使用高超滤率CRRT进行血液净化,比较2组患者抢救期生命体征、治疗效果、体内炎性介质水平、病死率及预后情况。结果 2组患者治疗后体温未见明显变化,观察组患者脉搏和呼吸低于对照组,P<0.05差异有统计学意义;观察组患者治疗24 h后APACHEⅡ评分和ALT低于对照组,P<0.05为差异有统计学意义。结论高超滤率CRRT在提高临床疗效的同时,生命体征更平稳,体内炎症介质量下降,降低了病死率。

Objective To analysis the effect of high filtration rate continuous renal replacement therapy in severe acute pancreatitis pa- tients. Methods According to the admission time ,56 severe acute panereatitis patients were divided into the observation group （from Jan. 2012 to Mar. 2013,26 cases ） and the control group （ from Apr. 2010 to Dec. 2011,30 cases）. The control group was given CRRT for hemopu- rification while the observation group was given high filtration rate CRRT. The vital signs of rescue period, treatment effect, inflammatory medi- um level, fatality rate and prognosis of the two groups were compared. Results There was no significant change in terms of temperature after operation in the two groups. Pulse and breathing in the observation group were lower than that of the control group with a significant difference （ P 〈 0.05 ）. APACHEⅡ and ALT of the observation group were lower than that of the control group 24 h after the operation, and the differ- ence is of statistical significance （ P 〈 0. 05 ）. Conclusion It would get a satisfactory effect to use high filtration rate CRRT in severe acute pancreatitis patients since it can obtain better treatment effect with more stable vital signs, lower inflammatory medium level and lower fatality rate.