连续性床旁血液净化治疗重症急性胰腺炎的效果

Effect of continuous bedside blood purification in the treatment of severe acute pancreatitis

目的探讨连续性床旁血液净化治疗重症急性胰腺炎的效果。方法选取2014年6月~2018年6月福建医科大学附属漳州市医院收治的50例重症急性胰腺炎患者作为研究对象,采用随机数字表法分为观察组(n=25)和对照组(n=25)。对照组患者采用常规治疗方法,观察组患者在此基础上采用连续性床旁血液净化治疗。观察两组患者的临床症状缓解情况、住院时间、炎症因子水平、急性生理和慢性健康评分(APACHEⅡ评分)及存活率。结果观察组的腹痛消失时间、腹胀缓解时间以及住院时间均短于对照组,差异有统计学意义(P<0.05)。治疗后,在白细胞介素-1、白细胞介素-6、白细胞介素-8、肿瘤坏死因子四项指标方面,观察组均低于对照组,差异有统计学意义(P<0.05);治疗后,两组患者的四项炎症因子指标均低于治疗前,差异有统计学意义(P<0.05)。治疗后,观察组的APACHEⅡ评分低于对照组,差异有统计学意义(P<0.05);治疗后,两组的APACHEⅡ评分均低于治疗前,差异有统计学意义(P<0.05)。在存活率方面,观察组高于对照组,差异有统计学意义(P<0.05)。结论对于重症急性胰腺炎患者采用连续性床旁血液净化,可有效缓解患者的临床症状,减少死亡病例,值得在临床上推广。

Objective To investigate the effect of continuous bedside blood purification in the treatment of severe acute pancreatitis.Methods A total of 50 patients with severe acute pancreatitis in Zhangzhou Affiliated Hospital of Fujian Medical University from June 2014 to June 2018 were selected as the research objects,and they were divided into the observation group(n=25)and the control group(n=25)by the random number table method.Patients in the control group were treated with conventional treatment methods,and patients in the observation group were treated with continuous bedside blood purification on this basis.The clinical symptom relief,hospitalization time,inflammatory factor levels,acute physiology and chronic health score(APACHEⅡscore)and survival rate of patients between the two groups were observed.Results The abdominal pain disappearance time,abdominal distension remission time and hospitalization time of the observation group were shorter than those of the control group,the differences were statistically significant(P<0.05).After treatment,the four indexes of interleukin-1,interleukin-6,interleukin-8 and tumor necrosis factor of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).After treatment,the four inflammatory factor indexes of the two groups were lower than those before treatment,and the differences were statistically significant(P<0.05).After treatment,the APACHEⅡscore of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).After treatment,the APACHEⅡscores of the two groups were lower than those before treatment,the differences were statistically significant(P<0.05).The survival rate in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion For patients with severe acute pancreatitis,continuous bedside blood purification can effectively relieve the clinical symptoms and reduce the death cases,which is worthy of clinical promotion.