短时血液滤过联合连续腹腔灌洗治疗急性重症胰腺炎

Short-time venous-venous hemofiltration combined with abdominal lavage on acute severe pancreatitis

目的 探讨短时血液滤过 (shorttimevenous-venoushemofiltrationSVVH)联合连续腹腔灌洗(abdominallavageAL)治疗急性重症胰腺炎(acuteseverepancreatitisASP)的临床疗效。 方法 在常规治疗的基础上同时加用短时血液滤过联合连续腹腔灌洗治疗 ,观察治疗前后外周血和腹腔中TNF -α ,IL -6,IL -8的改变以及APACHEII积分的改变。 结果 经短时血液滤过联合连续腹腔灌洗治疗 ,患者的临床表现明显好转 ,外周血和腹腔中细胞因子的浓度明显减少 ,APACHEII积分明显下降。结论 IL -6,IL-8 ,TNF - α 参与ASP的发病机制 ,短时血液滤过联合连续腹腔灌洗能有效清除急性重症胰腺炎时体内过度释放的细胞因子 ,降低APACHEII积分 ,减轻胰腺组织损害 ,有效控制全身炎症反应综合征(SIRS)。

Objective To study the therapeutic effects and its mechanism of short-time venous-venous hemofiltration (SVVH) combined with abdominal lavage (AL) on Acute Severe Pancreatitis(ASP).Methods Twenty-five patients with ASP were treated by the conventional theraputic mode therapy and SVVH combined with AL. The concentration of IL-6,IL-8 and TNF-a in plasma and abdominal fluid were measured, and APACHE II scores were compared before and after the trerapy.Results The therapy could reduce plasma and abdominal fluid IL-6,IL-8 TNF-a levels(p<0.01), and APACHE II Scores were significantly reduced (p<0.01).Conclusions IL-6,IL-8 and TNF-a may be involved in pathogenesis of ASP. The therapy can reduce plasma and abdominal fluid cytokines levels, alleviate pancreatic tissue damage. The therapy can control the systemic in flammatory response syndrome (SIRS) effectively.