运用连续性床旁血液净化对重症急性胰腺炎的治疗效果探究

Study on the Therapeutic Effect of Continuous Bedside Blood Purification on Severe Acute Pancreatitis

目的研析连续性床旁血液净化(CBP)运用在重症急性胰腺炎(SAP)患者治疗中的效果。方法方便择取2016年1月—2019年12月该院诊治的80例SAP患者为对象,依据治疗方案的差异将这些患者列入试验组、普通组,每组40例;普通组予以常规综合治疗,试验组在普通组方法的前提下实施CBP治疗,评比两组患者临床疗效、基础生命体征、各项症状缓解情况及治疗前后APACHE评分变化。结果治疗1周后,试验组患者临床总有效率97.50%显著高于普通组的77.50%,差异有统计学意义(χ^(2)=7.314,P=0.007);治疗后,试验组患者心率、呼吸、氧合、体温等生命体征指标正常占比率分别为77.50%、82.50%、82.50%、77.50%,显著高于普通组患者的47.50%、47.50%、40.00%、47.50%,差异有统计学意义(χ^(2)=7.680、10.769、15.221、7.680,P<0.05);试验组患者体温恢复时间(2.2±0.75)d、腹胀与腹痛消除时间(3.3±1.49)d、肠蠕动恢复时间(3.1±1.08)d都显著短于普通组的(3.8±1.29)d、(6.0±1.97)d、(4.5±1.59)d,差异有统计学意义(t=6.782、6.913、4.607,P=0.009、0.008、0.012);治疗前两组患者APACHEⅡ评分对照差异无统计学意义(t=0.124,P=0.875);治疗1周后,试验组患者APACHEⅡ评分(10.2±3.05)分显著低于普通组的(15.2±2.46)分,差异有统计学意义(t=8.070,P=0.005)。结论将CBP使用于SAP治疗中的疗效显著,可改善患者脏器功能,尽快缓解各项症状,使生命体征趋于平稳。

Objective To study the effect of continuous bedside blood purification(CBP)in the treatment of patients with severe acute pancreatitis(SAP).Methods 80 SAP patients diagnosed and treated in the hospital from January 2016 to December 2019 were conveniently selected as subjects.These patients were included in the experimental group and the general group,with 40 cases in each group according to the difference in treatment plan;the general group received conventional comprehensive treatment;the experimental group implemented CBP treatment under the premise of the normal group method,and evaluated the clinical efficacy,basic vital signs,relief of various symptoms and changes in APACHE scores before and after treatment in the two groups.Results After 1 week of treatment,the total clinical effective rate of 97.50%in the experimental group was significantly higher than 77.50%in the general group,the difference was statistically significant(χ^(2)=7.314,P=0.007);after treatment,the normal proportions of vital signs such as heart rate,respiration,oxygenation,and body temperature in the experimental group were 77.50%,82.50%,82.50%,and 77.50%,which were significantly higher than the 47.50%,47.50%,and 40.00%,47.50%of the ordinary group,the difference was statistically significant(χ^(2)=7.680,10.769,15.221,7.680,P<0.05).The patient's body temperature recovery time(2.2±0.75)d,abdominal distension and abdominal pain elimination time(3.3±1.49)d,and bowel movement recovery time(3.1±1.08)d were significantly shorter than those of the normal group(3.8±1.29)d,(6.0±1.97)d,(4.5±1.59)d,the difference was statistically significant(t=6.782,6.913,4.607,P=0.009,0.008,0.012).There was no statistically significant difference in the APACHEⅡscore between the two groups before treatment(t=0.124,P=0.875);after one week of treatment,the APACHEⅡscore(10.2±3.05)points of the experimental group was significantly lower than that of the normal group(15.2±2.46)points,the difference was statistically significant(t=8.070,P=0.005).Conclusion The use of CBP in SAP therapy has a significant effect,which can improve the patient's organ function,relieve symptoms as soon as possible,and stabilize vital signs.