不同时机行连续性肾替代治疗对重症急性胰腺炎疗效的影响

目的：探讨连续性肾替代治疗（ CRRT）时机对重症急性胰腺炎（ SAP）患者疗效的影响。方法回顾性分析38例重症急性胰腺炎患者的临床资料，按开始CRRT时机分为两组，早期组（21例）为重症急性胰腺炎发病后48 h内行连续性肾替代治疗，晚期组（17例）为48 h以后行连续性肾替代治疗，比较两组APACHEⅡ评分、ICU住院时间、28 d病死率。结果与早期组比较，晚期组第1、2天时APACHEⅡ评分均明显升高（ t＝2．231、2．304，均P＜0．05）；与早期组比较，晚期组入院时、CRRT开始时APACHEⅡ评分差异均无统计学意义（均P＞0．05）；与早期组比较，晚期组ICU住院时间、28 d病死率均明显升高（ t＝2．156，χ2＝4.293，均P＜0．05）；两组入院时年龄、性别、APACHE Ⅱ评分等差异均无统计学意义（均P＞0．05）。结论早期行CRRT治疗，可以降低SAP患者病死率，减少住院时间。

Effects of CRRT started at different time on patients with severe acute pancreatitis

Objective To explore the effects of continuous renal replacement thempy （ CRRT） on efficacy in severe acute pancreatitis （ SAP） patients based on different time .Methods A total of 38 SAP patients were divided into two groups randomly：early group（CRRT within 48h） for 21 patients and late group（CRRT after 48h）for 17 pa-tients.the APACHE II score,the length of stay ICU and the mortality of 28d were compared between the two groups . Results The APACHE Ⅱscore was significantly higher in late group than that in early group in day 1 and 2 （ t=2.231,2.304,both P〈0.05）;there is no significant differences between late group than that early group in APACHEⅡscore before treatment（P〉0.05）;the hospitalizing days and mortality were significantly higher in late group than that in early group（t=2.156,χ2 =4.293,both P〈0.05）;there was no significant differences between late group and early group in gender,age,APACHEⅡscore（all P〉0.05）.Conclusion Early CRRT can decrease both the hospi-talizing days and mortality in SAP patients .CRRT may provide more clinical benefits in the early phase （within 48h） of SAP.