CBP联合早期肠内营养治疗SAP合并高脂血症的效果分析

目的 观察连续性血液净化(CBP)联合早期肠内营养(EEN)治疗急性重症胰腺炎(SAP)合并高脂血症患者的效果.方法 选择该院2014年1月至2015年10月收治的SAP合并高脂血症患者56例,按照随机数字表法分为CBP加EEN组(联合组)和CBP组各28例,CBP组采用CBP治疗,联合组在CBP组的基础上联合EEN(入院后2d内)治疗.治疗后观察两组患者临床疗效及各项指标改善情况.结果 治疗后联合组总有效率(96.43％)高于CBP组(75.oo％),两组比较差异有统计学意义(P＜0.05);两组治疗后三酰甘油(TG)、尿淀粉酶(UAMY)、血脂肪酶(LPS)、血淀粉酶(SAMY)、C反应蛋白(CRP)、乳酸脱氢酶(LDH)等相关指标均有下降,其中联合组较CBP组下降更明显(P＜0.05).治疗后联合组急性生理学与慢性健康状况评分系统Ⅱ(APACHE-Ⅱ)评分明显低于CBP组(P＜0.05),联合组症状缓解时间及住院时间均短于CBP组(P＜0.05);联合组并发症发生率(10.71％)明显低于CBP组(28.57％),两组比较差异有统计学意义(P＜0.05).结论 CBP联合早期EEN可明显改善SAP患者的预后,有效减低患者并发症.

Effect of continuous blood purification combined with early enteral nutrition in treatment of acute severe pancreatitis complicating hyperlipidemia

Objective To observe the effects of continuous blood purification(CBP) combined with early enteral nutrition (EEN) in the treatment of acute severe acute pancreatitis(SAP) complicating hyperlipidemia.Methods Fifty-six cases of acute SAP complicating hyperlipidemia in our hospital from January 2014 to October 2015 were selected as the research subjects and divided into the CBP plus EEN group(combined group) and blood purification(BP) group according to the random digital table method,28 cases in each group.The CBP group was treated with CBP,while on the basis of CBP group the combined group was combined with EEN therapy (within 2 d after admission).The clinical efficacy and the improvement situation of various indexes after treatment were observed in the two groups.Results After treatment,the total effective rate in the combined group was 96.43 ％,which was higher than 75％ in the CBP group,the difference was statistically significant (P＜0.05);the related indicators of TG,UAMY,LPS,SAMY,CRP and LDH after treatment in the two groups were decreased,but which in the combined group were more significant compared with the CBP group(P＜0.05).After treatment,the APACHE-score in the combined group was significantly lower than that in the CBP group(P＜0.05),the symptom relief time and hospital stay time in the combined group were shorter than those in the CBP group (P＜0.05).The incidence rate of complications in the combined group was 10.71％,which was significantly lower than 28.57％ in the CBP group,the difference was statistically significant(P＜0.05).Conclusion CBP combined with EEN can significantly improve the prognosis of SAP patients and effectively reduces the complications.