连续性血液净化治疗重症胰腺炎患者临床观察

目的探讨连续性血液净化(CBP)治疗重症急性胰腺炎(SAP)的疗效。方法将我院2011年2月至2012年1月收治的20例SAP患者随机分为对照组和治疗组各10例,两组分别采用常规疗法和常规疗法+CBP治疗,治疗前及治疗6天后分别抽血检测血清空腹血糖(FBG)、白细胞(WBC)、淀粉酶(AMS)及氧化应激功能指标:超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-PX)、丙二醛(MDA)水平,比较两组上述指标改善情况。结果①治疗组治疗后FBG和AMS均有改善(P<0.05或<0.01),对照组仅有AMS有改善(P<0.01);且治疗后治疗组AMS改善程度明显好于对照组(P<0.01)。②治疗组治疗后SOD、CAT、GSH-PX和MDA均有改善(P<0.01),对照组观察指标改善情况均无统计学意义(P>0.05);且治疗后治疗组的SOD、CAT改善情况明显好于对照组。结论 CBP治疗SAP对患者异常增高的血糖、白细胞和淀粉酶有明显的改善作用,同时对患者的氧化应激功能紊乱有明显的纠正作用。

Clinical observation of continuous blood purification on patients with severe acute pancreatitis

Objective To discuss the curative effect of continuous blood purification(CBP)therapy for patients with severe acute pancreatitis(SAP).Methods 20cases with SAP and being hospitalized in our hospital from February,2011to January,2012were randomly divided into the control group and the treatment group with 10cases in each group.The control group was treated by the conventional therapy and the treatment group was treated by the combination of conventional therapy and CBP therapy.The fasting blood glucose(FBG),white blood cell(WBC),amylase(AMS)and oxidative stress function index including superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-PX),malondialdehyde(MDA)level were tested respectively before treatment and 6days after the treatment for each group.Then the improvement of these indexes of the two group above were compared.Results ①Indexes of FBG and AMS of the treatment group were all improved after treatment(P <0.05or 0.01),but only the AMS index was improved in the control group(P <0.01).The index of AMS in the treatment group was significantly more greatly improved than that in the control group(P <0.01).② The SOD,CAT and MDA,GSH-PX indexes of the treatment group were all improved after the treatment(P<0.01)and there was no statistical significance in index improvement of the control group(P >0.05).The SOD and CAT indexes of the treatment group were improved much more greatly than those of the control group.Conclusion CBP therapy has positive effect on improving SAP abnormal high blood sugar,white bloud cell and amylase of patients with SAP and can also improve patients’oxidative stress disorders.