早期高流量连续血液净化在重症急性胰腺炎中的应用

目的 探讨高流量连续血液净化(continuous blood purification,CBP)治疗时机对重症急性胰腺炎(severe acute pancreatitis,SAP)临床疗效及预后的影响.方法 回顾性分析2007-06/2010-06月作者医院收治的63例SAP患者,按照接受CBP治疗的时间分为2组:...

Application of Early High Flow Continuous Blood Purification in Patients with Severe Acute Pancreatitis

Objective To investigate the effect of treatment timing of high flow continuous blood purification（CBP） on therapy and prognosis of severe acute pancreatitis（SAP）.Methods A retrospective study was performed on the clinical material of 63 SAP patients treated with high flow CBP in our hospital.The patients were divided into 2 groups.Group A contained 32 cases undergoing CBP treatment within 72 hours after disease onset.Group B contained 31 cases undergoing CBP treatment at more than 72 hours but less than 120 hours after disease onset.Clinical symptoms and acute physiology and chronic health evaluationⅡ（APACHEII） scores were recorded before and after CBP treatment.The serum concentrations of cytokines including tumor necrosis factor alpha（TNF-α）,interleukin-6（IL-6）,IL-8 and IL-10 were measured using specific enzyme-linked immunosorbent assays（ELISA） before CBP treatment and at 6 hours,12 hours,24 hours,48 hours and 72 hours after treatment.Mechanical ventilation time,treatment time in Intensive Care Unit（ICU）,and 28-day mortality were compared between two groups.Results There was no statistical difference in APACHE II scores before treatment between two groups.Seventy-two hours after CBP treatment,time in ICU,28-day mortality,APACHE II score and serum cytokines levels of group A were decreased compared with group B（P0.05）.The mechanical ventilation time was less in group A but not significantly different from group B（P0.05）.Conclusion The preferable timing for high flow CBP treatment is within 72 hours after SAP onset.The therapeutic effect and prognosis can be significantly improved.