血液灌流术治疗高脂血症性重症急性胰腺炎

Clinical study on efficacy of hemoperfusion in treatment of hyperlipidemic severe acute pancreatitis

目的观察血液灌流术治疗高脂血症性重症急性胰腺炎（hyperlipidemic-severe acute pancreatitis HLSAP）的临床疗效。方法将2010年1月~2012年12月收治的36例HL-SAP患者随机分为常规治疗组18例和常规联合血液灌流术（hemoperfusion,HP）治疗组18例。比较两组患者第1、3、7天血清甘油三酯（TG）、C反应蛋白（CRP）、血糖（GLU）变化及临床APACHEⅡ评分。结果治疗第3、7天,常规联合血液灌流术治疗组较常规治疗组TG、CRP均明显下降（均P〈0.01）,血糖迅速控制（P〈0.01）,APACHEⅡ评分明显改善（P〈0.01）。结论血液灌流术可迅速降低血清甘油三酯,改善胰腺微循环,降低C反应蛋白,减轻炎症反应,并迅速稳定血糖水平,改善患者临床APACHE-Ⅱ评分,为临床治愈HL-SAP患者提供了一种有效的治疗手段。

Objective To explore the clinical efficacy of hemoperfusion on treatment of HL-SAP.Methods 36 patients with HL-SAP were randomly assigned into in conventional therapy group（18 cases,Control group）and conventional therapy combined with hemoperfusion treatment group（18 cases,HP group）.The changes of triglyceride（TG）,Creactive protein（CRP）,glucose（GLU）and the clinical APACHE-Ⅱ scores on day 1,day 3and day 7between both groups were compared.Results On day 3 and day 7,compared with Control group,HP group had more significantly decreased TG,CRP（P〈0.01）,more rapidly controlled GLU（P〈0.01） and more significantly improved ACPAHE-Ⅱscores（P〈0.01）.Conclusion The hemoperfusion can rapidly decrease TG,improve the pancreatic microcirculation,reduce the CRP and inflammation,and quickly stabilize the GLU level and improve the APACHE-Ⅱ scores,which provides an effective treatment method for patients with HL-SAP.