连续性肾脏替代疗法治疗重症急性胰腺炎的疗效观察

Continuous renal replacement therapy for severe acute pancreatitis treatment effect research

目的观察重症急性胰腺炎患者在使用连续性肾脏替代疗法(CRRT)后的最终治疗效果。方法随机挑选出26例重症急性胰腺炎患者为研究对象。其中普通组13例,采用常规疗法进行重症急性胰腺炎治疗;研究组13例,采用连续性肾脏替代疗法进行治疗。治疗过程中详细记录两组患者的血清TNF-α、IL-6数值和血气分析指标等相关指标变化,并观察比较两组患者的存活率。结果 26例重症急性胰腺炎患者死亡5例,治愈21例,存活率为80.8%,其中普通组死亡4例,存活率为69.2%;研究组死亡1例,存活率为92.4%。研究组存活率明显高于普通组,差异具有统计学意义(P<0.05)。经过一周的有效治疗,普通组患者的血清TNF-α、IL-6水平均高于治疗前,研究组者血清TNF-α、IL-6水平均低于治疗前(P<0.05);两组治疗后体温(T)、呼吸频率(RR)、白细胞计数(WBC)、脉搏、C-反应蛋白(CRP)均呈下降趋势(P<0.05),pH、PaO2/FiO2均呈上升趋势(P<0.05)。且组间比较研究组上述指标改善均明显优于普通组。结论连续性肾脏替代疗法治疗重症急性胰腺炎不仅治疗效果优于传统疗法,且最终存活率也很高,适合ICU病房用于重症急性胰腺炎的治疗。

Objective To observe patients with severe acute pancreatitis（ SAP） treated with continuous renal replacement therapy（ CRRT） after the final treatment effect. Methods Randomly selecting 26 patients with severe acute pancreatitis as the research object in this study. Normal group including 13 cases were treated using the conventional therapy for severe acute pancreatitis. Team in 13 cases was treated with the continuous renal replacement therapy for treatment. Detailed indexes were recorded in the process of treatment of two groups. Serum TNF alpha,IL-6 numerical and blood gas analysis and other related indicators of change were recorded and observed by means of comparison with CRRT treatment of survival. Results 5 of 26 cases of severe acute pancreatitis patients died,21 cases were cured. The survival rate was 80. 8%,while four cased died in ordinary group. The survival rate was 69. 2%. One case in the study group died,the survival rate was 92. 4%. Survival rate in the study group was significantly higher than that of the general group. The difference was statistically significant（ P〈0. 05）. After a week of effective treatment,the serum TNF-α,IL-6 values of the general group were higher than those of before treatment. The serum TNF-α,IL-6values of the studying group were lower than that of before treatment（ P〈0. 05）. Groups after treatment,the temperature（ T）,respiratory rate（ RR）,white blood cell count（ WBC）,pulse,C--reactive protein（ CRP） were decreased（ P 0.05）. pH,PaO2/ FiO2 showed an upward trend（ P〈0. 05）. A comparative study between these indicators showed that the improvement of the studying group were significantly better than ordinary group. Conclusion Continuous renal replacement therapy effect is better than traditional therapy. The ultimately survival rate is high,suitable for ICU ward for the treatment of severe acute pancreatitis.