综合治疗联合血液滤过治疗急性胰腺炎患者对心肾功能及血清APTT、PT水平的影响

目的探讨综合治疗联合血液滤过治疗急性胰腺炎(AP)患者对心肾功能及血清活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)水平的影响。方法选取2018年2月—2020年2月河北北方学院附属第一医院收治的重症急性胰腺炎(SAP)患者156例,按照随机数字表法分为对照组(n=75)和研究组(n=81),对照组患者采取常规综合治疗方法治疗,观察组患者在接受综合治疗的同时给予血液滤过治疗。比较两组患者治疗前、治疗7 d后心功能、肾功能、凝血功能、急性生理学与慢性健康状况评分系统(APACHEⅡ)评分以及转归情况。结果治疗后两组每搏输出量(SV)、心排出量(CO)及左室射血分数(LVEF)指标较治疗前高,研究组较对照组高组,差异显著(P<0.05)。治疗后两组血肌酐(Scr)、血尿素氮(BUN)指标低于治疗前,且研究组显著低于对照组,差异明显(P<0.05)。治疗后两组APTT、PT指标水平均较治疗前低,研究组较对照组低,差异显著(P<0.05)。研究组病死率3.70%显著低于对照组13.33%,差异有统计学意义(P<0.05)。结论综合治疗联合血液滤过治疗能改善SAP患者心肾功能及血清APTT、PT水平,降低患者病死率,值得广泛应用。

Effects of comprehensive treatment combined with hemofiltration on heart and kidney functions and serum APTT and PT levels in patients with acute pancreatitis

Objective To investigate the effects of comprehensive treatment combined with hemofiltration on the heart and kidney functions and serum activated partial thromboplastin time(APTT)and prothrombin time(PT)in patients with?severe acute pancreatitis(SAP).Methods One hundred and fifty-six SAP patients demographically and clinically matched were randomLy divided into 2 groups:control group(n=75),treated with conventional comprehensive treatment,and study group(n=81),treated with hemofiltration in addition while receiving comprehensive treatment.Heart function,renal function,blood coagulation function,acute physiology and chronic health(APACHEⅡ)scores and outcomes were compared between the two groups before treatment and 7 days after treatment.Results After treatment,stroke volume(SV),cardiac output(CO)and left ventricular ejection fraction(LVEF)of the two groups were higher than those before treatment,and the study group was higher than the control group(P<0.05).After treatment,blood creatinine(Scr)and blood urea nitrogen(BUN)of the two groups were lower than those before treatment,and the study group was significantly lower than the control group(P<0.05).After treatment,APTT and PT levels of the two groups were lower than before treat?ment,and the study group was lower than the control group(P<0.05).SSeven days after treatment,the mortality rate of the study group was 3.70%,significantly lower than that of the control group(13.33%,P<0.05).Conclusion Significantly im?proving the heart and kidney functions and serum APTT and PT levels,and reducing the APACHEⅡscoreand mortality?in SAP patients,comprehensive treatment combined with hemofiltration therapy is worthy of broad application.