连续性静脉-静脉血液滤过治疗重症急性胰腺炎的临床观察及护理

目的探讨采用连续性静脉-静脉血液滤过（continuous veno-venous hemofiltration,CVVH）治疗重症急性胰腺炎（severe acute pancreatitis,SAP）的临床疗效及护理措施。方法对2008年1月—2011年1月收治的27例SAP给予常规治疗的基础上实施CVVH治疗,观察患者生命体征、血氧饱和度及急性生理与既往健康评估Ⅱ评分（a-cute phisiology and chronic health evaluationⅡ,APACHEⅡ）变化,并给予常规护理和心理护理。结果本组治愈率为77.78%。治疗后24、48、72、96 h APACHEⅡ、体温、呼吸、心率均低于治疗前（P〈0.05,P〈0.01）,治疗后各时间点平均动脉压均低于治疗前,但仅治疗96 h与治疗前比较差异有统计学意义（P〈0.05）。结论应用CVVH治疗SAP效果满意,加强治疗过程中加强护理是保证治疗效果的关键。

Clinical Observation and Nursing Care of Continuous Veno-venous Hemofiltration in Treatment of Severe Acute Panreatitis

Objective To explore clinical effects and nursing intervention of continuous veno-venous hemofihration （CVVH） in treatment of severe acute pancreatitis （SAP）. Methods Twenty-seven patients with severe acute pancreatitis （SAP） during January 2008 and January 2011 were treated with CVVH on the basic of conventional treatment. Changes of patients＇vital signs, oxyhemoglobin saturations, acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ ） scores were observed, and usual care and mental nursing were conventionally given. Results The recovery rate was 77.78%. The APACHE Ⅱ scores, temperatures, respiration and heart rates at 24 h, 48 h, 72 h and 96 hours after treatment were significantly lower than those before treatment （ P 〈 0. 05 ,P 〈 0.01 ）. The mean arterial pressures at each time point after treatment were lower than those before treatment, only the decreasing of mean arterial pressure at 96 hours after treatment was statistically significant （P 〈 0.05 ）. Conclusion The CVVH therapy is effective in treatment of SAP, and enhancing nursing care during CVVH is the key point for therapy effect.