摘要
目的探讨血液吸附联合连续性血液净化治疗重症急性胰腺炎（SAP）合并急性肾损伤（AKI）的疗效。方法对22例重症急性胰腺炎合并急性肾损伤的患者,先给予内科治疗,在循环相对稳定后尽早（平均3.2±1.5天）给予血液吸附（HP）联合连续性静-静脉血液滤过（CVVH）。CVVH至少连续行72h后改为每天行8h,直至进入多尿期。22例患者行CVVH的时间72~232（平均120±26）h。HP每次2h,每隔24h治疗一次,共治疗5次,观察与比较治疗前后患者肾功能,小便量以及临床症状、体征、生化指标、APACHEⅡ评分的变化。结果 22例患者早期发热、心动过速、呼吸急促、等症状均得到明显缓解。4例患者死于多器官功能衰竭,1例死于真菌性败血症,1例死于急性呼吸窘迫综合征,2名患者因经济原因放弃治疗,余14例患者好转转普通病房。ICU存活率63.6%。结论 SAP合并AKI患者行CVVH联合HP能明显有益于患者肾功能的早期恢复,改善临床症状,提高患者的存活率,已成为SAP治疗中的重要措施之一。
Objective To investigate the therapeutic effects of early continuous veno-venous hemofiltration（CVVH）and hemoperfusion（HP）on patients with severe acute pancreatitis（SAP）.Methods 22 patients with SAP were treatment with conventional methods and CVVH＋HP for 72 hours at least.The kidney function,urine volume and APACHE Ⅱ were observed.Results 22 patients with fever,tachycardia,shortness of breath were all relieved.4 patients die of multi-organ function failure.1 patient died of fungal sepsis.1 patient died of acute respiratory distress syndrome.2 patients give up treatment because of the economic reason.The survival rate of 63.6%.Conclusion It is obvious that SAP merging with AKI can help patients on early kidney function restoration,improve clinic symptoms,and raise survival rate.
出处
《西部医学》
2011年第2期245-247,共3页
Medical Journal of West China
关键词
连续性血液净化
血液吸附
重症急性胰腺炎
急性肾损伤.
Continuous veno-venous emofiltration
Hemoperfusion
Severe acute pancreatitis
Acute kidney injury
