联合血液净化治疗应用于重症急性胰腺炎患者对炎症因子的影响及疗效

Effect of combined blood purification therapy on inflammatory factors in patients with severe acute pancreatitis and its efficacy

目的研究联合血液净化技术(血液灌流+持续性血液滤过)在重症急性胰腺炎治疗中的效果及对炎症因子的影响。方法选取本院2016年5月至2018年4月收治的90例重症急性胰腺炎患者为对象,根据治疗方法分组,每组45例,对照组接受常规治疗,观察组在对照组治疗措施基础上接受联合血液净化技术治疗,对比两组治疗前后的炎症因子水平等。结果治疗72h后,炎症因子TNF-α、IL-6、IL-8、CRP浓度对比:观察组均低于对照组,差异具有统计学意义(P<0.05);退热时间、肠蠕动恢复时间、血淀粉酶恢复时间、ICU入住时间、总住院时间对比:观察组均短于对照组,差异具有统计学意义(P<0.05);观察组病死率2.22%低于对照组病死率15.56%,差异具有统计学意义(P<0.05)。结论联合血液灌流和持续性血液滤过技术在重症急性胰腺炎治疗中应用快速缓解患者的炎症反应,维持内环境的稳定,提高抢救效果,值得推广。

Objective To study the effect of combined blood purification (hemoperfusion+continuous hemofiltration) in the treatment of severe acute pancreatitis and its influence on inflammatory factors. Methods 90 patients with severe acute pancreatitis admitted to our hospital from May 2016 to April 2018 were divided into two groups according to the treatment methods. The control group received routine treatment, the observation group received combined blood purification treatment on the basis of the treatment measures of the control group, and the levels of inflammatory factors before and after treatment were compared between the two groups. Results After 72 hours of treatment, the concentrations of inflammatory factors TNF-α, IL-6, IL-8 and CRP in the observation group were lower than those in the control group (P<0.05);the antipyretic time, intestinal peristalsis recovery time, blood amylase recovery time, ICU stay time and total hospitalization time in the observation group were shorter than those in the control group (P<0.05);The mortality of the observation group was 2.22%,which was lower than that of the control group was 15.56%(P< 0.05). Conclusion Combination of hemoperfusion and continuous hemofiltration in the treatment of severe acute pancreatitis in patients with rapid relief of inflammatory reaction,maintain the stability of the internal environment, improve the rescue effect,is worth promoting.