血液滤过治疗重症急性胰腺炎的疗效分析

目的:观察早期间断短时血滤(ISVVH)治疗重症急性胰腺炎(SAP)的临床疗效并探讨其机制。方法:50例SAP患者随机分为血滤组(HF组)30例进行ISVVH治疗,非血滤组(NHF组)20例未接受ISVVH治疗。对比观察两组患者的腹痛消失、腹胀缓解时间、APACHEⅡ评分以及促炎细胞因子(TNF-α、IL-1β、IL-6、IL-8)的变化。结果:治疗前,两组患者的APACHEⅡ评分无显著差异(P>0.05)。治疗后,HF组患者的腹痛消失、腹胀缓解时问明显缩短(P<0.05),APACHEⅡ评分显著降低(P<0.05),促炎细胞因子较入院时和NHF组有显著降低(P<0.05)。结论:SAP早期行ISVVH治疗可清除体内过多的促炎细胞因子,有利于控制病情,提高疗效。

Effect and Mechanism of Hemofiltration on Treatment of Severe Acute Pancreatitis

Objective To observe the effect and explore mechanism of early intermittent short veno-venuous hemofiltration （ISVVH） on the treatment of severe acute pancreatitis （SAP）. Methods 50 SAP patients were randomly divided into hemofiltration group （HF, 30 cases） accepted ISVVH therapy, and non-hemofiltration group （NHF, 20 cases） didn＇t accept the ISVVH therapy. APACHE II grades, abdominal symptom were recorded, and the concentration of serum pro-inflammatory cytokimes （TNF-o~, IL-1 3, IL-6, IL-8） were determined. Results Before ISVVH therapy, There was no significant difference in the APACHE II grades （P〉 0.05）. After ISVVH therapy, the APACHE II grades of HF group were significantly lower, the time of abdominal pain disappeared and abdonfinal distension remission were significantly shorter than those in NHF group （P 〈 0.05）, the levels of pro-inflammatory cytokines were significantly lower than those in NHF group and were lower than those before the ISVVH therapy. Conclusion Early ISWH can decrease pro-inflammatory cytokines, and the control the condition of SAP and enhance the efficacy.