HP联合CVVH治疗妊娠合并高脂血症性重症急性胰腺炎的临床研究

目的：观察血液灌流（HP）联合连续性静脉-静脉血液滤过（CVVH）的序贯血液净化方式治疗妊娠合并高脂血症性重症急性胰腺炎的临床效果。方法：将48例妊娠合并高脂血症性重症急性胰腺炎患者随机分为对照组22例和治疗组26例,在常规治疗的基础上,对照组接受CVVH,治疗组接受序贯血液净化。观察2组病死率、滤器使用寿命、总血液滤过时间、血液净化前及血液净化后72h的急性生理和慢性健康评分（APACHEⅡ）、血甘油三酯（TG）、总胆固醇水平（TC）、血淀粉酶（AMS）、谷丙转氨酶（ALT）、总胆红素（TBIL）、尿素氮（BUN）和肌酐（CRE）水平。结果：血液净化72h后2组APACHEⅡ评分及生化指标较治疗前均有不同程度的降低,其中血TG和TC水平治疗组较对照组下降更为明显（P〈0.05）,其他指标2组差异无统计学意义。与对照组比较,治疗组滤器使用寿命延长,总血液滤过时间减少（P〈0.05）,但2组病死率差异无统计学意义。结论：采用HP联合CVVH的序贯血液净化方式治疗妊娠合并高脂血症性重症急性胰腺炎可加快血TG下降速度,延长滤器使用寿命,缩短总血液滤过时间。

Clinical study of hemoperfusion combined with continous veno-venus hemofiltration treatment on hyperipidemic severe acute pancreatitis during pregnancy

Objective：To observe the clinical effect of sequential blood purification treatment of hemoperfusion（HP）combined with continous veno-venus hemofiltration（CVVH）on hyperlipidemic severe acute pancreatitis during pregnancy.Method：48patients with hyperlipidemic severe acute pancreatitis during pregnancy were divided into a control group（n=22）and a treatment group（n=26）randomly.In addition to the routine treatment,the control group received CVVH,and the treatment group received sequential blood purification.Mortality,filter service life,total hemofiltration time,acute physiology and chronic health levels of triglyceride（TG）and total cholesterol（TC）,blood amylase（AMS）,alanine aminotransferase（ALT）,total bilirubin（TBlL）,blood urea nitrogen（BUN）,creatinine（CRE）before blood purification and 72 hours after blood purification in two groups were observed.Result：The APACHEⅡ scores and biochemistry indexes 72 hours after blood purification were decreased in varying degrees compared to pretherapy in two groups,among which the blood levels of TG and TC were decreased more obviously in the treatment group compared to the control group（P〈0.05）,while other indexes showed no statistical difference between two groups.Compared to the control group,filter service life prolonged,total hemofiltration time decreased in the treatment group（P〈0.05）,but there was no statistical difference in mortality between two groups.Conclusion：Sequential blood purification treatment of HP combined with CVVH in hyperlipidemic severe acute pancreatitis during pregnancy can accelerate the descending rate of blood TG,prolong filter service life,shorten total hemofiltration time.