摘要
目的探讨短时血滤对重症急性胰腺炎的疗效及机理。方法２０例患者随机分为血滤组（ＨＦ组）和非血滤组（ＮＨＦ组），每组１０例。比较两组局部和全身表现，观察各时相点血液促炎细胞因子ＴＮＦα、ＩＬ１β、ＩＬ６、ＩＬ８和ｓＩＬ２Ｒ和抗炎细胞因子ＩＬ２及ＩＬ１０含量。结果ＨＦ及ＮＨＦ组腹痛消失和腹胀缓解时间为（８５±６３）ｈｖｓ．（９００±４９０）ｈ和（１６９±５２）ｈｖｓ．（６３４±３６０）ｈ；第１４天胰腺ＣＴ积分和第１０天ＡＰＡＣＨＥⅡ积分为（５６±１３）分ｖｓ．（７７±０８）分和（４５±１５）分ｖｓ．（７４±２１）分；住院天数和医疗费为（３３０±２０７）天ｖｓ．（５６４±１６０）ｄ和（５３２±１６０）万元ｖｓ．（８９１±２５０）万元，均为ＨＦ组较优（Ｐ＜００５）。治疗后ＨＦ组促炎细胞因子较ＮＨＦ组显著降低（Ｐ＜００５），抗炎细胞因子反较ＮＨＦ组显著升高（Ｐ＜００５）。结论重症胰腺炎早期短时血滤有利于纠正促炎细胞因子过度释放和促抗炎细胞因子失衡，使病情减轻，疗效提高。
Objective To estimate the effects of therapy of short veno venous hemofiltration (SVVH, 4hr) on severe acute pancreatitis (SAP). Methods Twenty patients were divided randomly into hemofiltration group (HF, 10 pts) and non hemofiltration group (NHF,10 pts). The local, systemic manifestations were compared between two groups; and the concentration of serum pro inflammatory cytokines (TNFα, IL 1β, IL 6 , IL 8 , sIL 2R) and anti inflammatory cytokines (IL 2, IL 10) were determined at different observation points. Results In the HF and NHF group, the duration for disappearance of abdominal pain and tenderness,and amelioration for abdominal distension was (8 5±6 3)d vs.(90 0±49 0)d and (16 9±5 2)d vs. (63 4±36 0) d. CT scores at the 14th day and APACHEⅡ scores at the 10th day was (5 6±1 3) vs. (7 7± 0 8) and (4 5±1 5) vs. (7 4±2 1). The average hospital stay and cost of therapy were (33 0±20 7)d vs. (56 4±16 0)d and (53200±16000) vs. (89100±25000) RMB( P <0 05). The concentration of 5 serum pro inflammatory cytokines at each observation points after hemofiltration was decreased significantly ( P <0 05) in the HF group. But the concentration of the two serum anti inflammatory cytokines was increased significantly ( P <0 05) as compared with that of the NHF group. Conclusions Through SVVH, the imbalance of pro inflammatory and anti inflammatory cytokines has been corrected at early stage; thus,the severity of the disease is ameliorated significantly and the efficacy of therapy is increased.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1999年第3期141-143,共3页
Chinese Journal of Surgery
