间断性肾脏替代治疗重症急性胰腺炎的临床观察

目的：探讨间断血液滤过治疗对重症急性胰腺炎（SAP）的临床疗效。方法：分析我科自2008 年10月～2011 年11月21例SAP患者行间断血液滤过治疗的疗效。观察治疗前后患者的体温、心率、呼吸、血压，检测肝肾功能、氧合指数(PO2／FiO2)、电解质、葡萄糖、血常规，并行APACHEⅡ评分。结果：21例SAP患者存活18例，死亡3例；经IRRT治疗后APACHEⅡ评分明显下降（P＜0.05），生命体征明显好转；生化指标明显改善（P＜0.05）。结论：常规综合治疗SAP同时，早期合理应用IRRT可以清除炎症介质，维持内环境稳定，改善脏器功能，提高疗效，为临床治疗SAP 提供一种重要辅助手段。

Clinical observation on intermittent renal replacement therapy in severe acute panreatitis

Objective To investigate the clinical effect of intermittent renal replacement therapy(IRRT) on severe acute panreatitis(SAP).Methods A total of 21 patients with SAP were received IRRT from Oct 2008 to Nov 2011,and the clinical data were retrospectively analyzed including the indications and related biochemical indicators in early stages(2-3 days).Results The signs of life,blood electrolytes,liver and renal function in biochemical indices and abdominal pain inflation and other symptoms were improved in the patients underwent IRRT.The scores of APACHEⅡ were apparently decreased.In these 21 patients,18 cases were cured,3 dead of multiple organs dysfunction syndrome.Conclusion IRRT treatment can keep stability of inner environment and the organ function in treatment of SAP.