间歇性腹膜透析在重症胰腺炎早期治疗中的应用研究

目的　比较间歇性腹膜透析（IPD）与连续性静脉-静脉血液透析（CVVHD）对重症胰腺炎早期炎症因子清除效果，分析IPD在重症胰腺炎早期治疗中的作用。方法　选取2015年10月至2020年10月在东莞东华医院接受治疗的24例重症胰腺炎患者为研究对象，其中2015年10月至2018年8月接受CVVHD的12例重症胰腺炎患者为对照组，2018年9月至2020年10月接受IPD的12例重症胰腺炎患者为观察组。观察组男8例、女4例，年龄（42.19±11.59）岁；对照组男7例、女5例，年龄（44.30±8.80）岁。对照组予内科保守治疗联合CVVHD，观察组予内科保守治疗联合IPD。收集两组患者基础资料、炎症因子及各实验室指标，并对相关指标进行分析。采用独立样本t检验、Fisher确切概率法。结果　两组患者在ICU住院时间、机械通气时间及并发症发生率上比较，差异均无统计学意义（均P>0.05）。两组患者第3天、第7天白介素-6（IL-6）、IL-10浓度差异均有统计学意义［（105.43±39.41）U/ml比（170.00±38.53）U/ml、（62.00±14.74）U/ml比（110.43±23.29）U/ml及（5.56±3.00）U/ml比（11.69±3.71）U/ml、（4.50±2.12）U/ml比（12.27±5.89）U/ml］（t=4.058、6.087、4.451、4.299，均P<0.001）。两组患者仅第3天肿瘤坏死因子-α（TNF-α）浓度差异有统计学意义［（12.72±3.82）μg/L比（8.18±2.98）μg/L］（t=3.246，P=0.004）。两组患者第1天、第7天C反应蛋白（CRP）浓度差异均有统计学意义［（53.75±11.47）mg/L比（111.72±60.34）mg/L、（75.75±18.98）mg/L比（123.58±47.57）mg/L］（t=3.269、3.235，P=0.003、0.004）。结论　IPD是重症胰腺炎早期治疗的有效手段。

Application of intermittent peritoneal dialysis in early treatment for severe pancreatitis

Objective　To compare the effects of intermittent peritoneal dialysis (IPD) and continuous veno-venous hemodialysis (CVVHD) on the removal of inflammatory factors in the early stage of severe pancreatitis, and analyze the role of IPD in early treatment for severe pancreatitis. Methods　A total of 24 patients with severe pancreatitis who received treatment in Dongguan Tungwah Hospital from October 2015 to October 2020 were selected as the research objects, including 12 patients with severe pancreatitis who received CVVHD from October 2015 to August 2018 as a control group and 12 patients with severe pancreatitis who received IPD from September 2018 to October 2020 as an observation group. The observation group included 8 males and 4 females, aged (42.19±11.59) years; the control group included 7 males and 5 females, aged (44.30±8.80) years. The control group was treated with medical conservative treatment combined with CVVHD, and the observation group was treated with medical conservative treatment combined with IPD. The basic data, inflammatory factors, and laboratory indicators in the two groups were collected, and the relevant indicators were analyzed. Independent sample t test and Fisher exact probability method were used. Results　There were no statistically significant differences in the length of ICU stay, duration of mechanical ventilation, and incidence of complications between the two groups (all P>0.05). There were statistically significant differences in the concentrations of interleukin-6 (IL-6) and IL-10 between the two groups on day 3 and day 7 (105.43±39.41) U/ml vs. (170.00±38.53) U/ml, (62.00±14.74) U/ml vs. (110.43±23.29) U/ml, (5.56±3.00) U/ml vs. (11.69±3.71) U/ml, (4.50±2.12) U/ml vs. (12.27±5.89) U/ml] (t=4.058, 6.087, 4.451, and 4.299; all P<0.001). There was a statistically significant difference in the concentration of tumor necrosis factor -α (TNF-α) between the two groups only on day 3 (12.72±3.82) μg/L vs. (8.18±2.98) μg/L] (t=3.246, P=0.004). There were statistically significant differences in the C-reactive protein (CRP) concentration between the two groups on day 1 and day 7 (53.75±11.47) mg/L vs. (111.72±60.34) mg/L, (75.75±18.98) mg/L vs. (123.58±47.57) mg/L] (t=3.269, 3.235; P=0.003, 0.004). Conclusion　IPD is an effective method in early treatment for severe pancreatitis.