CVVHDF模式在治疗重症急性胰腺炎的应用

目的探讨选用连续性静脉一静脉血液滤过透析（CVVHDF）模式治疗重症急性胰腺炎。方法对2011年1月至2013年6月我院中心ICU收治的24例急性重症胰腺炎进行回顾性分析。将24例患者随机分为两组，对照组14例给予胰腺炎常规治疗（禁食、胃肠减压、抑制胰酶分泌等）。治疗组在采用常规治疗同时联合床边CRRT治疗模式选择为：持续血液透析滤过（CVVHDF）。治疗72h后，比较两组治疗前后平均动脉压（MAP，）肌酐，尿素，尿量，降钙素原，C反应蛋白，乳酸变化情况。结果治疗组肌酐、乳酸、降钙素原、C反应蛋白显著下降，尿量增多，有显著性意义（P〈0．05）。对照组研究数据无明显差异。结论CVVHDF治疗重症急性胰腺炎可显著降低肌酐、乳酸、降钙素原、C反应蛋白，增加尿量，改善多脏器功能，值得临床推广。

CVVHDF mode in patients with severe acute pancreafitis

Objective To investigate continuous veno-venous hemofiltration dialysis mode of CVVHDF in treatment of severe acute pancreatitis. Methods Retrospective study of 24 SAP patients in our hospital was investigated. 24 patients were randomly divided into 2 groups, in the match group： Including 14 cases of acute pancreatitis were given conventional treatment of fasting （ gastrointestinal decompression, inhibition of pancreatic secretion etc ）. In the control group with conventional therapy and treatment mode combined with bedside CVVHDF selection. After the treatment of 72h, we compared two groups before and after treatment with the mean arterial pressure（ MAP）, creatinine, urea, urine volume, C reactive protein, lactic acid. Results In the control group, （MAP）,creatinine, urea, C reactive protein, lactic acid significantly decreased. Urine volume gradually increased. There was significant difference （P 〈 0. 05 ）. The match group had no significant difference between the research data. Conclusions CVVHDF in the treatment of severe acute pancreatitis can significantly reduce the inflammatory factors, improve organ function. It is worth the clinical promotion.