内科常规治疗联合床旁连续性肾脏替代疗法治疗急性重症胰腺炎的效果观察

Conventional medical treatment combined bedside continuous renal replacement therapy(CRRT)for severe acute pancreatitis(SAP)

目的探讨内科常规治疗联合床旁连续性肾脏替代疗法（CRRT）治疗急性重症胰腺炎（SAP）的临床效果。方法选取2010年1月～2014年6月医院ICU病房收治的50例SAP患者,随机分为对照组25例和治疗组25例;对照组给予常规内科综合治疗,治疗组在对照组基础上加CRRT治疗,观察两组治疗后的临床效果、症状缓解时间及治疗前后的APACHE评分、CTSI评分、CRP值变化,并进行分析。结果治疗组好转率优于对照组,并发症少于对照组,差异有统计学意义（P〈0.05）;治疗组腹痛、腹胀时间短于对照组,差异有统计学意义（P〈0.001）;治疗前两组APACHE评分、CTSI评分、CRP值差异无统计学意义（P〉0.05）;两组治疗前与治疗后APACHE评分、CTSI评分、CRP值比较差异有统计学意义（P〈0.001）;两组治疗后APACHE、CTSI评分、CRP值比较差异有统计学意义（P〈0.05）。结论CRRT联合内科常规治疗SAP效果显著,值得临床推广应用。

Objective To investigate the outcome of conventional medical treatment combined bedside continuous renal replacement therapy（CRRT）for treatment of severe acute pancreatitis（SAP）. MethodsFifty patients with severe acute pancreatitis cared by ICU of our hospital between January 2010 and June 2014 were involved in this study,all cases were randomly divided into a control group（n =25）and a treatment group（n =25cases）.Patients of the control group were given conventional medicine comprehensive treatment,the treatment group received CRRT treatment on the basis of conventional treatment as the control group.Observed the clinical effects of two groups after treatment,pre-and post-treatment the Acute Physiology and Chronic Health Evaluation（APACHE）score,CT severity index（CTSI）scoring,time to symptoms remission and C-reactive protein（CRP）value change.The data was statistically analyzed. Results The treatment group had superior response rate and less complications,compared to the control group,there were statistically significant differences（P〈0.05）;the treatment group had shorter abdominal pain and distension relief time than the control group,the comparison of the two groups yielded statistically significant differences（P〈0.001）.Group-paired comparison of pre-treatment APACHE scores,CTSI scores and CRP values yielded no statistically significant differences（P〉0.05）.The comparison of pre-treatment with post-treatment APACHE scores,CTSI scores and CRP values within each group showed statistically significant difference（P〈0.001）.After treatment,group-paired comparison of APACHE scores,CTSI scores and CRP values yielded statistically significant differences（P〈0.05）. Conclusion CRRT combined conventional medical treatment for SAP has satisfactory results and is worthy of clinical popularization.