血透治疗重症急性胰腺炎合并肾衰的疗效

目的:探讨血液灌流(HP)联合连续性静脉-静脉血液滤过(CVVH)治疗重症急性胰腺炎(SAP)合并急性肾损伤(AKI)的疗效。方法:选择ICU科收治的15例SAP合并AKI患者,常规治疗的同时,给予CVVH+HP治疗,观察效果。结果:15例患者中,11例患者最后好转出院,死亡4人,死亡率为26.7%(4/15);治疗24h后患者MAP、血肌酐、尿素氮及APACHEⅡ评分均较治疗前获得明显改善(P<0.05);PO2、WBC计数等指标在治疗48h后获得明显改善(P<0.05)。结论:对于SAP患者,在常规治疗的基础上加用CVVH+HP治疗,可有效清除炎症介质,促进肾功能的恢复,改善临床症状,提高患者存活率,是治疗SAP的有效措施。

Effects of hemoperfusion combing with continuous blood purification on severe acute pancreatitis complicated with acute kidney injury

Objective: To explore the effects of combination of continuous veno-venous hemofiltration(CVVH) and hemoperfusion(HP) on severe acute pancreatitis(SAP) complicated with acute kidney injury(AKI).Methods: A total of 15 patients with SAP and AKI were included in this study,these patients were given routine treatment and CVVH + HP therapy,effects were observed.Results: Of the 15 patients,11 were improved and discharged,4 died with the mortality rate of 26.7%(4/15).After 24h of treatment,MAP,serum creatinine,blood urea nitrogen and APACHE Ⅱ scores were all significantly improved than before(P<0.05).The PO2,WBC counts were also improved significantly after 48h of treatment(P<0.05).Conclusion:For patients with SAP,conventional treatment plus CVVH + HP therapy can eliminate inflammatory mediators,promote the recovery of renal function,improve clinical symptoms and raise patients' survival rate,thus it is an effective treatment for SAP.