早期血液净化+早期肠道去污治疗重症急性胰腺炎患者的效果研究

Study on the Effect of Early Blood Purification+Early Intestinal Decontamination on Patients with Severe Acute Pancreatitis

目的分析早期血液净化+早期肠道去污对重症急性胰腺炎(SAP)患者的疗效。方法回顾性分析2017年1月—2019年10月该院收治的SAP患者共42例,依据胰腺炎干预措施分成对照组14例和观察组28例,于基础治疗前提下,观察组予以早期血液净化+肠道去污,对照组未早期开展血液净化或(和)肠道去污,观察两组早期胰腺感染及多器官功能障碍综合征(MODS)发生率与后期脓肿形成率及真菌感染率,治疗后的膀胱压下降到15 mmHg以下、使用呼吸机、使用血管活性药物以及住院时间,住院费用和住院病死率情况。结果观察组早期胰腺感染、MODS发生率、后期真菌感染率分别为3.57%、3.57%、7.14%,比对照组21.43%、21.43%、35.71%更低,差异有统计学意义(χ^2=15.372、15.372、18.246,P<0.05);两组后期胰腺脓肿形成率对比,差异无统计学意义(P>0.05)。两组的使用呼吸机时间对比,差异无统计学意义(P>0.05);观察组的膀胱压下降到15 mmHg以下、使用血管活性药物以及住院时间分别为(6.21±0.85)、(5.14±0.48)、(15.46±3.26)d,比对照组更短,住院费用(22.14±3.65)万元比对照组(30.28±6.75)万元更少,差异有统计学意义(t=6.556、7.347、5.894、5.097,P<0.05),观察组病死率7.14%比对照组28.57%更低,差异有统计学意义(χ^2=4.656,P<0.05)。结论予以SAP患者早期血液净化+肠道去污效果显著,能减轻其临床症状,改善其预后,值推广应用。

Objective To analyze the effect of early blood purification+early intestinal decontamination on patients with severe acute pancreatitis(SAP).Methods A total of 42 SAP patients admitted to the hospital from January 2017 to October 2019 were retrospectively analyzed.Based on the pancreatitis intervention measures,they were divided into 14 cases in the control group and 28 cases in the observation group.Under the premise of basic treatment,the observation group received early blood purification+intestinal decontamination,the control group did not carry out blood purification or(and)intestinal decontamination early,and observe the incidence of early pancreatic infection and multiple organ dysfunction syndrome(MODS)and the rate of abscess formation and fungal infection in the two groups,after treatment,the bladder pressure drops below 15 mmHg,the use of ventilators,the use of vasoactive drugs,and the length of hospitalization,hospitalization expenses and hospital mortality.Results The early pancreatic infection,MODS incidence,and late fungal infection rates of the observation group were 3.57%,3.57%,and 7.14%,respectively,lower than those of the control group 21.43%,21.43%,and 35.71%,the difference was statistically significant(χ^2=15.372,15.372,18.246,P<0.05);Compare the formation rate of pancreatic abscess with the two groups in the later stage,the difference was not statistically significant(P>0.05).There was no significant difference in the ventilator time between the two groups(P>0.05);the bladder pressure in the observation group fell below 15 mmHg,the use of vasoactive drugs,and the length of stay were(6.21±0.85)d and(5.14±0.48)d,(15.46±3.26)d,shorter than the control group,the hospitalization expenses(22.14±3.65)ten thousand yuan was less than the control group(30.28±6.75)ten thousand yuan,the difference was statistically significant(t=6.556,7.347,5.894,5.097,P<0.05),The fatality rate of the observation group was 7.14% lower than that of the control group 28.57%,the difference was statistically significant(χ^2=4.656,P<0.05).Conclusion The effect of early blood purification+intestinal decontamination for SAP patients is significant,which can reduce their clinical symptoms and improve their prognosis,which is worthy of popularization and application.