早期血液滤过治疗急性重症胰腺炎合并间隔室综合征的疗效及对其血清IL-6、IL-8水平变化的影响

Efficacy of early hemofiltration in the treatment of acute severe pancreatitis complicated with compartment syndrome and its effect on serum IL-6 and IL-8 levels

目的研究早期血液滤过治疗急性重症胰腺炎合并间隔室综合征的疗效及对其血清白细胞介素(IL)-6、IL-8水平变化的影响。方法 78例急性重症胰腺炎合并间隔室综合征患者,依照治疗方案不同分为对照组和观察组,各39例。对照组予以常规治疗,观察组在对照组基础上联合早期血液滤过治疗。观察比较两组患者的体征消失时间、住院时间及治疗前后血清IL-6、IL-8水平。结果观察组患者的腹痛腹胀、恶心呕吐、腹膜刺激征消失时间及住院时间分别为(1.94±0.53)、(2.02±0.39)、(1.58±0.47)、(11.19±2.54)d,均短于对照组的(4.29±0.61)、(3.67±0.48)、(5.14±0.53)、(18.23±3.16)d,差异具有统计学意义(t=18.161、16.661、31.385、10.844,P<0.05)。治疗前两组患者的IL-6、IL-8水平对比,差异无统计学意义(P>0.05);治疗1、3 d后,观察组IL-6、IL-8水平均低于对照组,差异具有统计学意义(P<0.05)。结论早期血液滤过治疗急性重症胰腺炎合并间隔室综合征患者可加快体征消失,缩短住院时间,降低炎性因子水平。

Objective To study the efficacy of early hemofiltration in the treatment of acute severe pancreatitis complicated with compartment syndrome and its effect on serum interleukin（IL）-6 and IL-8 levels. Methods A total of 78 patients with acute severe pancreatitis complicated with compartment syndrome were divided by different treatment regimens into control group and observation group, with 39 cases in each group. The control group received conventional therapy, and the observation group received early hemofiltration therapy on the basis of the control group. Observation and comparison were made on sign disappearance time, hospitalization time and serum IL-6 and IL-8 levels before and after treatment between two groups. Results The observation group had abdominal pain and abdominal distension, nausea and vomiting, peritoneal irritation sign disappearance time and hospitalization time respectively as（1.94±0.53）,（2.02±0.39）,（1.58±0.47） and（11.19±2.54） d, which were all shorter than（4.29±0.61）,（3.67±0.48）,（5.14±0.53） and（18.23±3.16） d in the control group, and their difference was statistically significant（t=18.161, 16.661, 31.385, 10.844, P〈0.05）. Before treatment, both groups had no statistically significant difference in IL-6 and IL-8 level（P〉0.05）. After 1 and 3 d of treatment, the observation group had lower IL-6 and IL-8 level than the control group, and the difference was statistically significant（P〈0.05）. Conclusion Early hemofiltration in patients with severe acute pancreatitis complicated with compartment syndrome can speed up the disappearance of signs, shorten hospitalization time and lower the level of inflammatory factors.