连续静-静脉血液滤过对重症急性胰腺炎患者的疗效分析及护理干预

目的 观察连续静-静脉血液滤过(CVVH)治疗重症急性胰腺炎(SAP)的治疗作用及监护措施.方法 将2004年8月至2006年8月15例SPA患者作为对照组,2006年9月至2010年8月20例SPA患者为观察组,对照组采用常规治疗方法,观察组在常规治疗的基础上,采用连续床边血液滤过,观察2组患者治疗前后体温、心率、呼吸、血压及精神症状和腹部体征,监测肝肾功能,并进行APACHEⅡ评分.结果 观察组治疗后体温、心率、呼吸、血压、腹部症状、临床指标、APACHE Ⅱ评分与对照组比较差异显著,观察组治疗10 d后多器官功能障碍综合征(MODS)、多器官功能衰竭(MOF)的发生率明显低于对照组.结论 采用连续静-静脉血液滤过可早期纠正SAP引起的全身炎性反应,改善全身状况,并能有效防止并发症的发生,正规的技术操作及精心护理能保证CVVH顺利进行,减少CVVH引起的并发症.

Abstract：

Objective To observe continuous venous-venous hemofiltration (CVVH) for treatments and cares of severe acute pancreatitis(SAP). Methods From August 2004 to August 2006, 15 cases with SAP were in conventional treatment (the control group), from September 2006 to August 2010, 20 cases with SAP were nursed with CVVH(the observation group). We surveyed patients' vital signs (including body temperature, heart rate, breathing and blood pressure),mental symptoms, abdominal signs and monitored liver and kidney functions. Additionally we executed APACHE Ⅱ scores. We analyzed them retrospectively. Results The afore - mentioned indexes of two groups were significant in statistics, the observation group had lower incidence of MODS、MOF than the control group after 10 days caring. Conclusions The CVVH could correct systemic inflammatory reaction of SAP and prevent complications. Standard technical operation and intensive nursing can ensure smooth process of CVVH and decrease complications caused by CVVH.

Effect of continuous venous-venous hemofiltration on patients with severe acute pancreatitis and nursing

Objective To observe continuous venous-venous hemofiltration (CVVH) for treatments and cares of severe acute pancreatitis(SAP). Methods From August 2004 to August 2006, 15 cases with SAP were in conventional treatment (the control group), from September 2006 to August 2010, 20 cases with SAP were nursed with CVVH(the observation group). We surveyed patients' vital signs (including body temperature, heart rate, breathing and blood pressure),mental symptoms, abdominal signs and monitored liver and kidney functions. Additionally we executed APACHE Ⅱ scores. We analyzed them retrospectively. Results The afore - mentioned indexes of two groups were significant in statistics, the observation group had lower incidence of MODS、MOF than the control group after 10 days caring. Conclusions The CVVH could correct systemic inflammatory reaction of SAP and prevent complications. Standard technical operation and intensive nursing can ensure smooth process of CVVH and decrease complications caused by CVVH.