摘要
目的观察早期血液灌流(HP)联合连续静脉-静脉血液滤过(CVVH)对高脂血症性重症急性胰腺炎(HLSAP)的治疗效果。方法 39例HLSAP患者随机分为2组:HP+CVVH组(A组,n=19),对照组(B组,n=20)。在常规治疗基础上,A组加用HP联合CVVH治疗。观察治疗前后两组患者的心率(HR)、血压(BP)、氧合指数(PaO2/FiO2)、血清甘油三酯(TG)、白介素-6(IL-6)、C反应蛋白(CRP)等指标变化,并进行APECHA-Ⅱ动态评分,比较两组治愈率及ICU住院天数。结果经HP+CVVH治疗72h后,HR、BP趋于稳定,症状明显改善,APECHA-Ⅱ评分明显下降[(13.2±2.5)vs(18.5±2.7),P<0.05],TG、IL-6、CRP亦明显下降[(6.4±3.5)vs(37.5±6.9),(53.1±7.6)vs(97.5±11.2),(31.3±6.3)vs(67.4±10.3),均P<0.05]。A组ICU平均住院时间明显缩短(13d vs 18d,P<0.05),死亡率明显减少(0 vs 12.5%,P<0.05)。结论早期经HP联合CVVH对治疗HLSAP有明显效果,能有效改善患者病情及预后,减少ICU住院时间,降低死亡率。
Objective To observe the treatment effect of, Hemoperfusion（HP） combined continuous veno-venous hemofiltration（CVVH） in patients with hyperlipidemic severe acute pancreatitis（HLSAP）. Methods Thirty-nine HLSAP patients were randomly divided into two groups： HP＋CVVH group （A,n=19） and control group （B,n--20）. Both groups underwent conventional therapy, and patients in group A additionally underwent HP＋CVVH. Heart rate（HR）, respiration, POtFiO2, triglyceride（TG）, IL-6 and CRP were monitored. APACHE ]I score was used to evaluate patients＇condition. The survival rate and the avrage ICU hospitalization days were compared between the two groups. Results After treatment by HP＋ CVVH, HR, respiration, APACHE 1] [（13.2 ± 2.5） vs （18.5 ± 2.7）,P 〈 0.05] as well as serum levels of TG, IL-6 and CRP[（6.4 ± 3.5） vs （37.5 ± 6.9）, （53.1 ＋ 7.6） vs （97.5± 11.2）, （31.3 ± 6.3） vs （67.4 ± 10.3）, all P 〈 0.051 decreased significantly. In group A,the ICU length of hospital stay were significantly decreased （13 vs 18, P 〈 0.05）. Compared to group B, group A had a lower mortality rate （0 vs 12.5%, P 〈 0.05）. Conclusion HP＋CVVH is effective in treating HLSAP and is associated with a lower case fatality rate, also can reduce the ICU length of hospital stay.
出处
《中国医药科学》
2013年第18期16-18,共3页
China Medicine And Pharmacy
