延长每日血液滤过治疗重症急性胰腺炎的疗效观察

目的:探讨延长每日血液滤过(extended daily hemofiltration,EDHF)对重症急性胰腺炎(severe acute pancreatitis,SAP)的治疗效果。方法:回顾分析62例SAP在72h内各时间点的生命体征、相关生化指标及最终转归。其中30例患者的急性生理及慢性健康评分II(APACHE II)评分为(17.53±4.31),在传统常规治疗的基础上接受EDHF治疗(常规治疗+EDHF治疗组);另32例患者的APACHE II评分为(15.84±3.88),接受传统常规方法治疗(常规治疗组)。结果:常规治疗+EDHF治疗组从开始接受治疗到治疗后72h内,患者的体温、心率等生命体征,血常规、C反应蛋白、肌酐和血白蛋白等相关生化指标及腹痛、腹胀等自觉症状均较常规治疗组改善更显著;常规治疗+EDHF治疗组患者的住院时间较常规治疗组短[(12.3±7.1)d比(19.2±8.4)d,P<0.05];2组病死率无显著差异(16.7%比28.1%,P>0.05)。结论:EDHF对SAP患者的体温、心率以及C反应蛋白等相关生化指标和腹痛、腹胀等自觉症状均有显著改善作用,并且能缩短患者住院时间,但对患者的病死率无显著影响。

Effects of Extended Daily Hemofiltration on Severe Acute Pancreatitis

Objective：To investigate the therapeutic effects of extended daily hemofiltration（EDHF） on severe acute pancreatitis（SAP）.Methods：The clinical data of 62 patients with SAP were retrospectively reviewed,including life vital signs,biochemical indexes and prognosis within 72 h.30 cases with an average acute physiology and chronic health evaluation II（APACHE II） score of（16.3±4.3） underwent EDHF on the basis of traditional treatment;another 32 cases with an average APACHE II score of（15.2±3.6） were treated traditionally.Results： From the beginning to 72 h after treatment,the vital signs,the biochemical indexes（such as body temperature,heart rate） and the biochemical indexes（such as C-response protein,creatinine,blood albumim,abdominal pain and abdominal distension） were improved more obviously in patients who received EDHF treatment than those who only received traditional treatment.Patients treated with EDHF needed shorter hospitalization time than patients treated conventionally[（12.3±7.1） d vs.（19.2±8.4） d,P〈0.05].There was no significant difference in mortality rate between EDHF treatment group and conventional treatment group（16.7%vs.28.1%,P〉0.05）.Conclusions： EDHF treatment can improve the symptoms of SAP patients,such as body temperature and heart rate;and it can also improve some of the biochemical indexes,such as C-response protein,abdominal pain and abdominal distension.Moreover,EDHF can shorten hospitalization time,but EDHF has no significant effects on mortality rate.