早期血液滤过联合血液灌流治疗急性重症胰腺炎的临床观察

Clinical observation of early hemofiltration combined hemoperfusion therapy in severe acute pancreatitis

目的观察早期血液滤过联合血液灌流(HF/HP)治疗急性重症胰腺炎(SAP)的疗效。方法回顾性分析82例确诊SAP患者的病历资料,在常规治疗的基础上辅以HF/HP治疗,观察并比较治疗前后患者生命体征、精神神经症状、腹部体征及生化指标等变化。结果 82例SAP患者中,67例治疗7～10 d后,临床症状明显缓解,急性生理和慢性健康评分(APACHE-Ⅱ评分)下降,血淀粉酶、肝肾功能、血气分析等指标显著改善(P<0.05),总有效率为81.7%。结论早期采用HF/HP治疗SAP安全有效,显著改善了SAP的预后。

Objective To observe the clinical effect of early hemofiltration combined hemoperfusion(HF/HP) therapy in severe acute pancreatitis(SAP).Methods 82 patients diagnosed as SAP in our hospital were recruited and their clinical data were retrospectively analyzed.In addition to traditional treatment,all the patients accepted HF/HP therapy.Results All 82 patients well tolerated HF/HP therapy,67 of them with clinical symptom obviously relieved.Acute physiology and chronic health(APACHE-II) score were significantly decreased(P<0.05).The serum amylase,liver and kidney function,blood gas analysis,and other indicators were significantly improved and the total effective rate was 81.7%.Conclusion Individualized comprehensive treatment combined with early HF/HP could significantly reduce the mortality of SAP.