不同透析法治疗重症急性胰腺炎的比较(附101例病例)

Comparison of Different Dialysis Methods for Treating Severe Acute Pancreatitis(with A Report of 101 Cases)

[目的]探讨一种高效、低价、并发症发生率低的治疗重症急性胰腺炎(severe acute pancreatitis,SAP)的方法。[方法]回顾性研究101例SAP于常规综合治疗、早期短时间断血液滤过(intermittent short veno-venuous hemofiltration,ISVVH)、连续静脉-静脉血液滤过(continuous veno-venous hemofiltration,CVVH)、腹膜透析(peritoneal dialysis,PD)、PD+ISVVH治疗方法下的费用、住院时间、开腹手术比例、死亡率及并发症发生率,并进行各组的比较。[结果]ISVVH组、CVVH组、PD组、PD+ISVVH组分别与常规治疗组比较,均显优势(P<0.01或P<0.05);PD+ISVVH组住院时间、死亡率、开腹手术比例、腹内高压持续时间在与其他组的比较中均最显优势;费用的比较中,CVVH组费用最高,PD组与PD+ISVVH组费用相当,也明显低于其余各组(P<0.05)。在并发症发生率方面,PD+ISVVH组均显低明显,与其余组比较,差异有统计学意义(P<0.01或P<0.05)。[结论]PD+ISVVH是一种有效、价廉、并发症发生率低的治疗SAP的有效方法。

[Objective] To discuss a high-efficacy, low-price method for severe acute pancreatitis（SAP） with low rate of complications. [Method] Trace back and study 101 cases of SAP for routine comprehensive therapy, early intermittent short veno-venuous hemofiltration（ISVVH） continuous venovenous hemofiltration（CVVH）, peritoneal dialysis（PD） and PD＋ISVVH on their cost, in-hospital period, laparotomy ratio, death rate and complication rate. [Result] Comparing routine treatment group with groups of ISVVH,CVVH,PD and PD ＋ ISVVH respectively, it had advantages; PD＋ISVVH group was better than other groups on in-hospital period, death rate, laparotomy ratio and abdominal high-pressure sustaining period; on cost comparison, CVVH group was the highest, group PD and group PD ＋ ISVVH were most similar, but also markedly lower than other groups. On complications, group PD＋ISVVH was lowest,having statistical meaning compared with other groups（P〈0.01 or P〈0.05）. [Conclusion] PD ＋ ISVVH is an effective, low-cost method for treating SAP, with low comphcation rate.