早期血液滤过在治疗重症急性胰腺炎中的应用

Effect of early therapy of hemofiltration on the patients with severe acute pancreatitis

目的 探讨早期血液滤过治疗重症急性胰腺炎的疗效。方法 60例重症急性胰腺炎病人随机分为血滤组(HF)和非血滤组(NHF),每组30例。观测两组间APACHEⅡ评分、CT积分、局部和全身表现及体液细菌培养。结果 HF组及NHF组第10天APACHEⅡ评分和胰腺CT积分分别为(4.7±1.6)及(7.5±2.1)和(5.2±0.9)及(7.3±1.2)(P<0.05);HF组及NHF组腹痛消失时间和腹胀缓解时间分别为(24.5±12.3)h及(64.0±34.6)h和(18.9±5.2)h及(48.4±26.0)h(P<0.05);HF组体液细菌培养阳性率(26.7％)显著低于NHF组(53.3％),平均住院时间显著缩短,HF组(21±4)d,NHF组(32±7)d(P<0.05)。结论 重症急性胰腺炎病人行早期血液滤过治疗能有效缓解临床症状,改善重症急性胰腺炎的预后。

Objective To investigate the effect of early therapy of hemofiltration on the patients with severe acute pancreatitis (SAP). Methods Sixty patients were divided randomly into hemofiltration group (HF, 30patients) and no-hemofiltration group (NHF, 30patients). Scores of APACHEⅡ and CT, culture of bacteria and the local, systemic manifestations were compared between two groups. Results In the HF group and NHF group, the durations for disappearance of abdominal pain and tenderness, and amelioratoion for abdominal distension were (24.5±12.3)h vs. (64.0±34.6)h and (18.9±5.2)h vs. (48.4±26.0)h respectively(P<0.05). CT scores and APACHEⅡ scores at the 10th day were (5.2±0.9)vs. (7.3±1.2) and(4.7±1.6)vs. (7.5±2.1) (P<0.05). Positive rate of bacteria culture in HF group (26.7%) was significantly lower than that of NHF group (53.3%). The duration of average hospital stay in HE group (21±4)d was markedly shorter than that of NHF group (32±7)d(P<0.05). Conclusions Hemofiltration in the early period is an effective therapeutic option for SAP and can improve the prognosis of SAP.