连续性血液净化治疗重症急性胰腺炎合并多器官功能障碍综合征的疗效分析

Therapeutic Effect of Continuous Blood Purification on Severe Acute Pancreatitis Complicated with Multiple Organ Dysfunction Syndrome

目的分析在重症急性胰腺炎(SAP)合并多器官功能障碍综合征(MODS)患者临床治疗过程中应用连续性血液净化后的治疗效果。方法选取2016年1月-2019年1月该院收治的50例重症急性胰腺炎合并多器官功能障碍综合征患者,随机分为研究组和参照组,各25例。其中参照组接受常规内科综合治疗,研究组采用连续性血液净化治疗,比较患者治疗前后的APACHEⅡ评分、MODS评分和细胞因子水平。结果治疗前,两组各项评分差异无统计学意义(P>0.05);治疗后研究组患者APACHEⅡ评分(9.84±2.35)分和MODS评分(4.97±1.53)分均低于参照组(t=5.653、3.263,P<0.05)。治疗前,两组患者IL-6、TNF-α和CRP细胞因子水平差异无统计学意义(P>0.05);治疗后,研究组患者IL-6 (128.43±18.62)ng/mL、TNF-α(88.96±17.56)ng/mL和CRP(75.31±21.29)mg/L均低于参照组(t=8.044、11.592、10.653,P<0.05)。结论连续性血液净化能够有效改善重症急性胰腺炎合并多器官功能障碍综合征患者受损的脏器功能,清除炎症介质,治疗效果显著,值得推广应用。

Objective To analyze the therapeutic effect of continuous blood purification in patients with severe acute pancreatitis (SAP) complicated with multiple organ dysfunction syndrome (MODS). Methods Fifty patients with severe acute pancreatitis complicated with multiple organ dysfunction syndrome admitted to our hospital from January 2016 to January 2019 were randomly divided into study group and reference group, 25 cases each. The reference group received conventional medical comprehensive treatment, and the study group used continuous blood purification treatment to compare APACHE Ⅱ score, MODS score and cytokine level before and after treatment. Results Before treatment, there was no statistically significant difference between the two groups (P>0.05). After treatment,the APACHE Ⅱ score (9.84±2.35)points and MODS score (4.97±1.53)points were lower in the study group than in the reference group (t=5.653, 3.263, P<0.05). There was no statistically significant difference in IL-6, TNF-α and CRP cytokine levels between the two groups before treatment (P>0.05). After treatment, the study group patients IL-6 (128.43±18.62) ng/mL, TNF-α(88.96±17.56) ng/mL and CRP (75.31±21.29) mg/L were lower than the reference group (t=8.044, 11.592, 10.653, P<0.05). Conclusion Continuous blood purification can effectively improve the damaged organ function in patients with severe acute pancreatitis complicated with multiple organ dysfunction syndrome, clear the inflammatory mediators, and the therapeutic effect is remarkable. It is worthy of popularization and application.