血液净化治疗重症胰腺炎和急性呼吸窘迫综合征的疗效观察

Therapeutic effect of blood purification on severe pancreatitis and acute respiratory distress syndrome

目的探索血液净化治疗重症胰腺炎和急性呼吸窘迫综合征的疗效。方法选取2017年4月一2019年4月于三亚中心医院(海南省第三人民医院)接受治疗的128例重症胰腺炎并发急性呼吸窘迫综合征患者为研究对象,按照随机数表法分为两组,观察组应用持续血液净化及常规治疗,对照组应用常规治疗。采用APACHEⅡ量表对患者健康状况进行评分,采用胰腺炎临床评价量表结合呼吸系统疾病诊疗标准对患者临床疗效进行评价,检测血清白介素-6(IL-6)、肿瘤坏死因子(TNF-α)、C反应蛋白(CRP)指标水平。结果治疗前两组患者APACHEⅡ评分对比差异不具有统计学意义(P>0.05);治疗后观察组APACHEⅡ评分显著低于对照组,差异具有统计学意义(P<0.05)。观察组共发现21例治愈.38例有效,对照组共发现14例治愈、27例有效,观察组总.有效率显著高于对照组,差异具有统计学意义(P<0.05)。治疗前两组患者IL-6、TNF-α、CRP指标水平对比差异不具有统计学意义(P>0.05);治疗后观察组IL-6.TNF-α.CRP指标水平显著低于对照组,差异具有统计学意义(P<0.05)。结论血液净化结合常规治疗能够有效改善重症胰腺炎并发急性呼吸窘迫综合征患者健康状况,提高临床疗效的同时缓解患者炎症反应,适合临床推广治疗。

Objective To explore the efficacy of blood purification in the treatment of severe pancreatitis and acute respiratory distress syndrome.Methods 128 patients with severe acute pancreatitis complicated with acute respiratory distress syndrome who were treated in our hospital from April 2017 to April 2019 were enrolled in the study.They were divided into two groups according to the random number table method.The observation group used continuous blood purification and conventional treatment,the control group used conventional treatment.The APACHEⅡscale was used to score the patient's health status.The clinical evaluation of the pancreatitis elinical evaluation scale combined with the diagnosis and treatment of respiratory diseases was used to detect serum interleukin-6(IL-6)and tumor necrosis factor(TNF-α),C-reactive protein(CRP)index level.Results There was no significant diference in the APACHEⅡscore between the two groups before treatment(P>0.05).The APACHEⅡscore in the observation group was signifcantly lower than that in the control group(P<0.05).A total of 21 cases were cured in the observation group,38 cases were ffective.In the control group,14 cases were cured and 27 cases were ffective.The total ffective rate of the observation group was significantly higher than that of the control group,and the difference was staistically significant(P<0.05).There was no significant difference in the levels of IL-6,TNF-αand CRP between the Iwo groups before treatment(P>0.05).Afer treatment,the levels of IL-6,TNF-x and CRP in the observation group were significanly lower than those in the control group,the difference was statistically sigificant(P<0.05).Conclusion Blood purification combined with conventional treatment can ffctively improve the health status of patients with severe acute pancreatitis complicated with acute respiratory distress syndrome,improve clinical effieacy and relieve the inflammatory response of patients,and is suitable for clinical promotion and lreatment.