连续性血液净化在重症急性胰腺炎治疗中的应用

目的 观察连续性血液净化(CBP)治疗在重症急性胰腺炎(SAP)患者治疗中的作用.方法 将26例SAP患者随机分为常规组和CBP组,常规组给予传统常规治疗,CBP组在常规治疗基础上,给予CBP治疗.观察2组患者治疗前及治疗后2、5 d的APACHEⅡ评分、C-反应蛋白(CRP);2组的机械通气时间、住ICU时间及病死率.结果 常规组治疗2、5 d后的APACHEⅡ评分为:11.61±3.00、10.76±4.30,CRP为:(149.71±60.06)、(101.21±33.98)mg/L;CBP组相应为:8.20±1.87、6.19±1.49,(109.17±23.91)、(70.83±25.45)mg/L,2组间差异有统计学意义(P均＜0.05);常规组机械通气时间、住ICU时间、病死率为:(13.29±6.23)、(16.00±6.86)d,21.43%(3/14);CBP组相应为(8.00±5.27)、(10.33±4.81)d,8.33%(1/12),2组间差异有统计学意义(P均＜0.05).结论 CBP可以有效改善SAP患者的APACHEⅡ评分,降低CRP,缩短机械通气时间及住ICU时间,降低病死率,应在临床工作中推广应用.

Effect of continuous blood purification on severe acute ancreatitis

Objective To investigate the effect of continuous blood purification(CBP) in the patients with severe acute pancreatitis(SAP). Methods Twenty-six patients with severe acute pancreatitis were divided into the control group and the observation group randomly. Fourteen cases in the control group were given conventional treatment only, 12 cases in CBP group were given continuous blood purification as well as the conventional treatment. The APACHE Ⅱ score and CRP of pre- and intra-treatment at the 2nd and 5th day were observed in the two groups. The duration of mechanical ventilation, the duration of ICU stay, the mortality of hospital were observed as well. Results The APACHE Ⅱ score and CRP of the second day and the fifth day of intra-treatment in the control group were 1.61±3.00,10.76±4.30, (149.71±60.06) mg/L and (101.21±33.98) mg/L, respectively, which were significantly different to those of (8.20±1.87) mg/L, (6.19±1.49) mg/L, (109.17±23.91) mg/L,(70.83±25.45)mg/L in the CBP group(P＜0.05). The duration of mechanical ventilation,the duration of ICU stay and the mortality of hospital were (13.29 ± 6.23) d, (16.00 ± 6.86) d, 21.43% in the control group, which were significantly lower than those of (8.00 ±5.27)d,(10.33 ±4.81)d,8.33% in the other group (P ＜0.05).Conclusions CBP is an effective method for the patients with severe acute pancreatitis to shorten the duration of mechanical ventilation and the ICU stay,and decrease the mortality of hospital.