腹腔灌洗术联合高容量血液滤过对重症急性胰腺炎患者免疫细胞亚群的影响

Effects of peritoneal lavage combined with high-volume hemofiltration on immune cell subsets in patients with severe acute pancreatitis

目的探讨腹腔灌洗术与高容量血液滤过联合治疗重症急性胰腺炎(SAP)的效果及对患者免疫细胞亚群的影响。方法选取SAP患者120例,随机分为对照组与观察组,各60例。所有患者均在常规治疗基础上给予连续静脉-高容量血液滤过治疗,观察组在此基础上联合实施腹腔灌洗术。治疗72h后,对比两组炎症因子水平与免疫细胞亚群水平变化情况,记录并发症发生率。结果治疗后,观察组炎症因子水平较对照组低(P<0.05);观察组CD4+、CD4+/CD8+水平较对照组高(P<0.05);两组CD8+水平比较差异无统计学意义(P>0.05)。治疗后观察组各并发症发生率均低于对照组(P<0.05)。结论腹腔灌洗术联合高容量血滤过治疗SAP疗效较单用高容量血滤过好,患者全身炎症反应明显减轻,机体免疫功能提高,并发症好转显著,联合治疗安全有效。

Objective To explore the efficacy of peritoneal lavage combined with high-volume hemofiltration on severe acute pancreatitis(SAP)and its effects on immune cell subsets.Methods 120 cases of patients with SAP who were admitted to our hospital from January in 2016 to January in 2018 were selected and divided into control group and observation group with 60 cases in each group according to the random number table method.All patients were given continuous venous high-volume hemofiltration on the basis of routine treatment,and observation group was combined with peritoneal lavage on this basis.After 72 h of treatment,the levels of inflammatory factors and immune cell subsets were compared between the two groups,and the incidence rate of complications was recorded.Results After treatment,the levels of inflammatory factors in observation group were lower than those in control group(P<0.05).The levels of CD4+and CD4+/CD8+in observation group were higher than those in control group(P<0.05).There were no statistical significantly differences in the level of CD8+(P>0.05).After treatment,the incidence rate of complications in observation group was lower than that in control group(P<0.05).Conclusion Peritoneal lavage combined with high-volume hemofiltration has better efficacy on severe acute pancreatitis than single high-volume hemofilt ration alone,and the former one can significantly reduce systemic inflammatory response,and improve the immune function and the complications,therefore the combined therapy is safe and effective.