连续性血液滤过在重症胰腺炎治疗中的应用分析

Analysis of Application of Continuous Hemofiltration in Treatment of Severe Acute Pancreatitis

目的探讨连续性血液滤过治疗重症胰腺炎的临床疗效。方法随机选取2014年2月—2016年2月该院收治的60例重症胰腺炎患者,在常规治疗的基础上,对所有患者给予连续性血液滤过治疗,对比患者治疗前与治疗后24 h的临床症状,观察治疗前与治疗后24 h的生化指标,包括血总胆红素(TB),天冬氨酸转氨酶(AST),血清淀粉酶(AMS),尿素氮(BUN)以及相关不良反应的发生情况。结果连续性血液滤过治疗后,患者的症状均得到明显的改善,治疗前生化指标血总胆红素(TB),天冬氨酸转氨酶(AST),血清淀粉酶(AMS),尿素氮(BUN)分别为(44.5±13.8)mol/L、(126.5±64.7)U/L、(757.8±239.8)U/L、(15.5±3.3)mmol/L;治疗24 h后生化指标血总胆红素(TB),天冬氨酸转氨酶(AST),血清淀粉酶(AMS),尿素氮(BUN)分别为(27.3±9.3)mol/L、(97.8±45.9)U/L、(447.8±106.5)U/L、(6.5±1.3)mmol/L,治疗前与治疗后对比,生化指标均明显降低,差异有统计学意义(P<0.05)。治愈出院有48例,存活率为80.0%,死亡12例,死亡率为20.0%,差异有统计学意义(P<0.05)。结论对于重症胰腺炎患者,早期应采取连续性血液滤过治疗,可以促进重症胰腺炎患者的康复,显著提高其治疗效果,提高患者的存活率,值得临床推广和借鉴。

Objective To discuss the clinical curative effect of continuous hemofiltration in treatment of severe acute pancreatitis. Methods 60 cases of patients with severe acute pancreatitis admitted and treated in our hospital from February2014 to February 2016 were randomly selected and all patients were treated with Continuous hemofiltration, and the 24 h clinical symptoms of patients before and after treatment were compared after treatment, and the 24 biochemical indicators including TB, AST, AMS, BUN and occurrence of related adverse reactions before and after treatment were observed. Results After treatment, the symptoms were obviously improved, and the TB, AST, AMS and BUN of the biochemical indicators before treatment were respectively（44.5 ±13.8）mol/L,（126.5 ±64.7）U/L,（757.8 ±239.8）U/L,（15.5 ±3.3）mmol/L and（27.3±9.3）mol/L,（97.8±45.9）U/L,（447.8±106.5）U/L,（6.5±1.3）mmol/L at 24 h after treatment, and the biochemical indicators obviously decreased and the difference had statistical significance（P〈0.05）, and 48 cases of patients were discharged after cure, and the survival rate was 80.0%, 12 cases died, and the survival rate was 20.0%, and the difference had statistical significance（P〈0.05）. Conclusion For patients with severe acute pancreatitis, the continuous hemofiltration in the early stage can promote the rehabilitation of patients with severe acute pancreatitis, obviously improve the treatment effect and improve the survival rate of patients, which is worth clinical promotion and reference.