CRRT在重症胰腺炎治疗中的应用研究

Application of CRRT in treatment of severe acute pancreatitis

目的:探讨连续性肾脏替代疗法(CRRT)在重症急性胰腺炎(SAP)治疗中的效果。方法:回顾性分析2012-01~2016-12我院早期行CRRT治疗的22例SAP患者(CRRT组)及同期单纯内科保守治疗的53例SAP患者(对照组)的临床资料,对两组患者72h内生命体征、血钾(K^+)、血清尿素氮(BUN)、肌酐(Cr)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)等进行比较分析。结果:治疗后CRRT组24h体温、心率、尿量、K^+较治疗前明显好转,而对照组的变化并不显著。CRRT组72h血清BUN、Cr、CRP、IL-6、TNF-α浓度均下降,对照组的血清BUN、Cr、CRP下降但差于CRRT组(P<0.05),而IL-6、TNF-α浓度升高。结论:早期行CRRT能快速有效地改善SAP临床症状,清除体内有害物质,疗效确切。

Objective：To investigate the effect of continuous renal replacement therapy（CRRT）application in treatment of severe acute pancreatitis（SAP）.Methods：The clinical data of 22 cases of SAP（CRRT group）patients received early CRRT treatment in our hospital from January 2012 to December 2016,and 53 cases of SAP patients（control group）received simple internal medicine conservative treatment were analyzed retrospectively,vital signs,potassium（K-＋）,serum urea nitrogen（BUN）,creatinine（Cr）,C-reactive protein（CRP）,tumor necrosis factor alpha（TNF-α）,interleukin 6（IL-6） within 72 hours of two groups were compared.Results：The 24 hours of body temperature,heart rate,urine,potassium（K-＋） of CRRT group was improved obviously,the change is not significant in control group,72 hours serum BUN,Cr,CRP,IL-6,TNF-αconcentration decreased in CRRT group,serum BUN,Cr and CRP in control group also decreased but poor than CRRT group（P〈0.05）,IL-6,TNF-αconcentration increased.Conclusion：SAP early treatment with CRRT can quickly improve clinical symptoms,remove harmful substances in the body,showed certain curative effect,and is the key to high-quality individualized care and treatment.