血浆置换治疗高脂血症性急性胰腺炎的时机选择和疗效评价

Timing and efficacy evaluation of plasma exchange in the treatment of hyperlipidemic acute pancreatitis

目的 分析对于高脂血症性急性胰腺炎患者进行血浆置换的选择时机,追踪患者预后,评价治疗效果.方法 选取2011年1月至2015年1月高脂血症性急性胰腺炎患者60例,根据实施血浆置换的时间分为早期治疗组和择期治疗组,统计患者病史、临床症状、危重症评分、住院时间等资料,同时记录血生化、降钙素原、淀粉酶等指标,比较其治疗前后的变化,配对比较病史资料和严重程度相近的病例,根据临床症状的改善、生化指标的转变及预后评价疗效.结果 择期血浆置换组患者治疗效果及预后优于早期治疗组（P＜0.05）.结论 血浆置换是治疗高脂血症性急性胰腺炎的有效举措,其治疗时机值得深入探讨,并非如文献提示的越早效果越好.

Objective To observe the timing of plasma exchange with hyperlipidemic acute pancreatitis patients by retrospective analysis,tracking the prognosis of the patients and evaluate the efficacyof the treatment.Methods From January 2011 to January 2015,60 patients with hyperlipidemic acute pancreatitis were selected according to the opportunity of plasma exchange,and they were divided into early treatment group（28 cases） and the selective treatment group（32 cases）.The patient＇s medical history,clinical symptoms,critical illness score,hospitalization time and other information were statistically analyzed.Blood biochemical,calcitonin and amylase were recorded at the same time,and compared the changes of original and amylase index before and after the treatment,paired comparisons of cases with similar medical history and severity.Therapeutic effects were evaluated by the improvement of clinical symptoms and biochemical change and prognostic.Results The therapeutic effect and prognosis of the patients of elective plasma exchange group were better than those of the early treatment group （P 〈0.05）.Conclusions Plasma exchange is an effective measure in treatment of hyperlipidemic acute pancreatitis,the timing of the treatment is worth further discussion,but not the earlier the better as the current literature suggests.