连续性血液净化及肠内营养治疗重症胰腺炎疗效及对炎症因子影响

Clinical Efficacy of Continuous Blood Purification and Enteral Nutrition in the Treatment of Severe Pancreatitis and Its Effect on the Inflammatory Factors

目的:探究连续血液净化及肠内营养治疗重症胰腺炎患者的疗效及对患者炎症因子水平的影响。方法:选择2018年1月至2019年12月于我院接受治疗的82例重症胰腺炎患者为研究对象,按照治疗方式不同将其分为研究组(49例)与对照组(33例)。对照组患者仅接受连续血液净化,研究组患者在对照组患者基础上加用肠内营养支持,对比两组患者腹痛缓解时间、感染发生率、住院时间、治疗前后血尿素氮(Blood urea nitrogen,BUN)、血肌酐(creatinine,SCr)、C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子(tumor necrosis factor,TNF-α)、急性生理与慢性健康评分表评分(acute physiology and chronic health evaluationⅡ,APACHE Ⅱ)评分的变化。结果:研究组患者腹痛缓解时间、感染发生率、住院时间均短于对照组患者(P<0.05)。治疗后,研究组患者APACHE Ⅱ评分、血清CRP、IL-6、TNF-α、BUN及SCr水平均低于对照组(P<0.05)。结论:连续血液净化联合肠内营养支持对重症胰腺炎患者具有较好的治疗效果,能够显著加快重症胰腺炎患者转归,改善患者肾损伤及机体炎症状态。

Objective: To explore the clinical efficacy of continuous blood purification and enteral nutrition in the treatment of patients with severe pancreatitis and its effect on the levels of inflammatory factors in patients. Methods: Eighty-two patients with severe pancreatitis who were treated in our hospital from January 2018 to December 2019 were selected as the research subjects, and they were divided into the experimental group(49 cases) and the control group(33 cases) according to different treatment methods. Patients in the control group received continuous blood purification only, and the patients in the experimental group were supplemented with enteral nutrition on the basis of the patients in the control group. The changes in abdominal pain relief time, infection rate, length of hospital stay,BUN, SCr, CRP, IL-6, TNF-α, and APACHE Ⅱ scores before and after treatment were compared between the two groups of patients.Results: Abdominal pain relief time, infection rate, and hospital stay were shorter in the experimental group than in the control group(P<0.05). After treatment, the APACHE Ⅱ score, serum CRP, IL-6, TNF-α, BUN, and SCr levels in the experimental group were lower than those in the control group(P<0.05). Conclusion: Continuous blood purification combined with enteral nutrition support had a better therapeutic effect on patients with severe pancreatitis, could significantly accelerate the outcome of patients with severe pancreatitis, and improve patients renal injury and inflammation of the body.