15例连续性血液净化治疗重症急性胰腺炎合并多器官功能障碍综合征的疗效观察与护理

目的观察15例重症急性胰腺炎合并多器官功能障碍综合征（MODS）患者接受连续性血液净化治疗的效果，并总结护理经验。方法15例重症急性胰腺炎合并MODS患者接受连续性血液净化治疗72h，记录并比较治疗前后患者的生命体征、APACHEII评分，未使用机械通气患者抽血化验血气分析指标，比较其治疗前后的呼吸频率、脉氧及氧合指数变化情况，统计救治成功率，总结重症急性胰腺炎合并MODS患者血液净化及重症监护治疗的护理措施。结果重症急性胰腺炎合并MOBS患者连续性血液净化治疗72h后心率、体温及APACHElI评分下降，较治疗前差异有统计学意义（P〈0．01）；7例未使用呼吸机患者治疗后的呼吸频率较治疗前下降（P〈0．05），脉氧及氧合指数较治疗前显著升高（P〈0．01）；15例患者最终救治成功12例，3例死亡，存活率80％。结论连续性血液净化治疗对重症急性胰腺炎合并MODS患者救治效果良好，救治过程中需要做好血液净化治疗和重症监护治疗相关的护理工作。

Effect observation of continuous blood purification on treatment of 15 severe acute pancreatitis patients with multiple organ dysfunction syndrome and related nursing

Objective To observe the therapeutic effect of continuous blood purification on the treatment of 15 severe acute pancreatitis（SAP）patients with multiple organ dysfunction syn- drome （MOI）S） and summarize the nursing experience. Methods 15 SAP patients with MODS were treated with continuous blood purification for 72 hours. Vital signs, APACHE II score were recorded and compared before and after treatment. Respiratory frequency, pulse oxygen and oxy- genation index changes were compared before and after treatment in patients in patients without mechanical ventilation. Survival rate was recorded and nursing measures for SAP patients with MODS by treatment of continuous blood purification were summarized. Results 72 hours after continuous blood purification, heart rate, body temperature and APACHE I] score decreased in SAP patients with MODS , and there were significant differences before and after treatment （ P 〈 0.01 ）; in 7 ptients without mechanical ventilation, the respiratory frequency was significantly lower than that before treatment（P 〈 0.05）, and pulse oxygen and oxygenation index were signifi- cantly increased than those before treatment （P 〈 0.05） ; among 15 patients, 12 patients survival,3 patients died , and the survival rate was 8 0 % . Conclusion Continuous blood purification shows a significant therapeutic effect on the treatment of SAP patients with MODS. In the pro- cess of rescue, correlated nursing measures on continuous blood purification and intensive care treatment should be well arranged.