血液净化联合中药治疗重症急性腺炎的疗效观察

目的探讨连续性血液净化(CBP)联合中药治疗重症急性胰腺炎(SAP)的临床疗效。方法60例SAP患者随机分为治疗组(30例)和对照组(30例),全部患者一经确诊即给予常规治疗方案,包括:重症监护、维持水电平衡、抑制胰腺分泌、预防性应用抗生素、全胃肠外营养和器官功能支持等,治疗组在常规治疗基础上,给予CBP及中药治疗。分别观察2组患者治疗后APACHE II评分、腹痛缓解时间、第1次排便时间、血淀粉酶下降速度、入院后再发MODS及胰腺、胰周感染发生率、中转手术率、病死率、平均住院日数。结果与对照组相比,治疗组腹痛缓解时间、第1次排便时间、平均住院日数均显著缩短,血淀粉酶下降速度明显增快,APACHE II评分、入院后再发MODS及胰腺、胰周感染发生率、中转手术率、病死率均显著降低,差异有统计学意义(P<0.05或P<0.01)。结论CBP联合中药治疗SAP作用协同,相互补充,是SAP早期行之有效的辅助治疗措施。

Therapeutic effect of combining continuous blood purification with traditional Chinese medicine on severe acute pancreatitis

Objective To investigate the therapeutic effect of combining continuous blood purification(CBP) with traditional Chinese medicine on severe acute pancreatitis(SAP).Methods 60 cases with SAP were randomly divided into treatment group(30 cases) and control group(30 cases).The conventional therapy was given in all patients,included liquid resuscitation,oxygen therapy,abrosia,alleviating pain,continuous gastrointestinal decompression,using proton pump inhibitor and somatostatin,prophylactic application of antibiotic,total parenteral nutrition and organ function support,etc.Treatment group was additional given CBP plus traditional Chinese medicine.The APACHE II score,relieving time of abdominal pain,the time of first defecation,rate of decay of hemodiastase,the incidence of pancreatic abscess and multiple organ dysfunction syndrome(MODS),operation rate,mortality rate and the mean hospitalized days after treatment were observed and compared.Results Compare with control group,the relieving time of abdominal pain,the time of first defecation and the mean hospitalized days in the treatment group were significantly lessen,otherwise,the rate of decay of hemodiastase was significantly faster,furthermore,the APACHE II score,the incidence of pancreatic abscess and MODS,operation rate and mortality rate were significantly lower(P<0.05 or P<0.01).Conclusion Continuous blood purification plus traditional Chinese medicine was effective assistant method for early stage of severe acute pancreatitis.