连续性静脉-静脉血液滤过技术在重症急性胰腺炎治疗中的应用

目的观察联合连续性静脉-静脉血液滤过技术（CVVH）和内科常规治疗用于重症急性胰腺炎（SAP）的临床疗效。方法 30例SAP患者在接受内科常规治疗的同时给予连续性静脉-静脉血液滤过（CVVH）3 d,观察治疗前和治疗3 d后的患者症状,进行APACHEⅡ评分,检测血肌酐、血淀粉酶、C反应蛋白（CRP）的变化情况。结果治疗3 d后患者发热、心动过速、呼吸窘迫、腹痛、腹胀等症状明显缓解,APACHEⅡ评分改善,血肌酐、血淀粉酶、C反应蛋白水平均明显低于治疗前（P〈0.01）。结论在非手术常规治疗的基础上早期联合CVVH治疗SAP,能有效缓解病情,保护器官功能,降低病死率,其明显的临床效果可能与清除体内炎症介质有关。

Effectiveness of continuous venovenos hemofiltration on severe acute pancreatitis

Objective To observe the clinical effects of continuous venovenos hemofiltration（CVVH）with general medical therapies for severe acute pancreatitis（SAP）.Methods 30 patients with severe acute pancreatitis ac-cepted CVVH for 3 days on the basis of general medical therapies.Observed the symptom of pre-treatment and after 3-days therapies,then got the scores of acute physiology and chronic health evaluation Ⅱ.Detected the variation of Scr,serum amylase,C-reactive protein.Results After 3 days treatment,symptoms of febrile,tachycardia,respirato-ry distress,abdominalgia and abdominal distention relieve obviously.The scores of acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ）decreased.The level of Scr,serum amylase and C-reactive protein descended sig-nificantly（P0.01）.Conclusion Combined with CVVH early on the basis of non-operative general medical thera-pies for SAP may effectively relieve the disease,protect the function of organs,decrease the mortality of SAP,and the mechanism may be related to the remove of mediators of inflammation.