| 连续性肾脏替代治疗单用及联合血液灌流、血浆置换在高脂血症性重症急性胰腺炎的疗效评价 |
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| 引用本文： | 李虎年,胡海丽,魏宗婷,史君星,赵旭,刘杰. 连续性肾脏替代治疗单用及联合血液灌流、血浆置换在高脂血症性重症急性胰腺炎的疗效评价[J]. 中国动脉硬化杂志, 2018, 26(4): 394-399 |
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| 作者姓名： | 李虎年 胡海丽 魏宗婷 史君星 赵旭 刘杰 |
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| 作者单位： | 湖北医药学院附属人民医院重症医学科 |
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| 摘 要： | 目的探讨连续性肾脏替代治疗(CRRT)血液灌流(HP)联合连续性静脉-静脉血液滤过治疗(HP/CVVH)、血浆置换(PE)联合连续性静脉-静脉血液滤过治疗(PE/CVVH)对高脂血症性重症急性胰腺炎(HLSAP)的治疗价值及效果评价。方法将68例HLSAP患者随机分为CVVH组、HP+CVVH组和PE+CVVH组,均予重症急性胰腺炎常规治疗,并分别予以单纯CVVH、HP+CVVH、PE+CVVH治疗。比较治疗前和治疗72 h后三组患者生命体征、APACHEⅡ评分、甘油三酯(TG)、C反应蛋白(CRP)、重要脏器功能指标变化值;CT检查评价治疗前与治疗1周后CT严重程度指数(CTSI)变化;记录治疗1周内主要并发症发生率、平均住院天数及死亡率。结果三组患者治疗前各项指标差异无显著性。但各组患者治疗后各项指标均有好转(P0.05),治疗72 h后三组间APACHEⅡ评分、血和尿淀粉酶比较差异均无统计学意义(P0.05);HP+CVVH、PE+CVVH两组与CVVH组比较其余实验室指标改善更明显(P0.05)。治疗1周后三组患者CTSI均较治疗前下降(P0.05),且HP+CVVH组和PE+CVVH组较CVVH组改善更明显(P0.05)。HP+CVVH组和PE+CVVH组较CVVH组临床情况更好,死亡率低,住院时间短(P0.05)。结论 HP、PE联合CVVH治疗较单纯CVVH治疗能够更快降低患者血TG水平,改善临床症状,可减少系统炎性反应综合征及多器官功能障碍综合征/多器官功能衰竭的发生,有效降低死亡率,减少住院时间。
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| 关 键 词： | 高脂血症 重症急性胰腺炎 连续性肾脏替代治疗 血液灌流 血浆置换 |
| 收稿时间： | 2017-08-09 |
| 修稿时间： | 2017-10-20 |
Evaluation of continuous renal replacement therapy in combination with hemoperfusion and plasma exchange in hyperlipidemic severe acute pancreatitis |
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| LI Hu-Nian,HU Hai-Li,WEI Zong-Ting,SHI Jun-Xing,ZHAO Xu and LIU Jie. Evaluation of continuous renal replacement therapy in combination with hemoperfusion and plasma exchange in hyperlipidemic severe acute pancreatitis[J]. Chinese Journal of Arteriosclerosis, 2018, 26(4): 394-399 |
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| Authors: | LI Hu-Nian HU Hai-Li WEI Zong-Ting SHI Jun-Xing ZHAO Xu LIU Jie |
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| Affiliation: | Department of Critical Care Medicine, People''s Hospital Affiliated to Hubei University of Medicine, Shiyan, Hubei 442000, China,Department of Critical Care Medicine, People''s Hospital Affiliated to Hubei University of Medicine, Shiyan, Hubei 442000, China,Department of Critical Care Medicine, People''s Hospital Affiliated to Hubei University of Medicine, Shiyan, Hubei 442000, China,Department of Critical Care Medicine, People''s Hospital Affiliated to Hubei University of Medicine, Shiyan, Hubei 442000, China,Department of Critical Care Medicine, People''s Hospital Affiliated to Hubei University of Medicine, Shiyan, Hubei 442000, China and Department of Critical Care Medicine, People''s Hospital Affiliated to Hubei University of Medicine, Shiyan, Hubei 442000, China |
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| Abstract: | |
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| Keywords: | Hyperlipidemic Severe acute pancreatitis Continuous renal replacement therapy Hemoperfusion Plasmapheresis |
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