摘要
目的探讨连续性血液净化(continuous blood purification,CBP)治疗重症急性胰腺炎(severe acute pancreatitis,SAP)合并多器官功能障碍(multiple organ dysfunction syndrome,MODS)患者效果以及对患者血液流变学、血清炎症因子的影响。方法选取我院2012年3月至2017年3月收治的SAP合并MODS患者62例为研究对象,根据治疗方法不同,将纳入研究的62例患者非随机分为观察组(n=30)和对照组(n=32)。对照组行常规疗法,观察组在常规疗法基础上行连续性血液净化(continuous blood purification,CBP)。比较两组治疗疗效、急性生理与慢性健康评分表评分(APACHE II评分)、MODS评分、血液流变学指标、血清炎症因子在治疗前后的变化。结果观察组治疗总有效率为90.00%,对照组治疗总有效率为68.75%,差异有统计学意义(P<0.05);治疗后,观察组APACHE II、MODS评分分别为(8.12±1.33)分和(4.31±1.56)分,对照组APACHE II、MODS评分分别为(12.46±1.87)分和(6.44±1.93)分,差异有统计学意义(P<0.05);治疗后,观察组全血比黏度高切、血浆比黏度、血小板黏附率分别为(5.37±0.16)map/s、(1.76±0.08)%和(34.57±15.68)%,均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组血清TNF-α、IL-6、IL-10和CRP分别为(68.45±8.94)ng/m L、(67.24±8.58)ng/m L、(57.50±7.26)ng/m L和(69.37±9.23)mg/L,均低于对照组,差异有统计学意义(P<0.05)。结论 CBP治疗SAP合并MODS患者效果良好,可有效改善血液流变学,降低血清炎症因子水平,阻止病情进一步发展。
Objective To investigate the therapeutic effect of continuous blood purification（CBP）in the treatment of severe acute pancreatitis（SAP）complicated with multiple organ dysfunction syndrome（MODS）,and its influence on hemorheology and serum inflammatory cytokines. Methods 62 patients with SAP complicated with MODS received in our hospital from March 2012 to March 2017 were selected as study subjects and divided into observation group（ n =32）and control group（ n =32）according to therapeutic schemes.Patients in control group received routine treatment and patients in observation group received CBP in addition to routine treatment.The curative effect,acute physiological and chronic health score（APACHE II score）,MODS score,changes of hemorheology indicators and serum inflammatory cytokines after treatment were compared. Results The total responsive rate of observation group was 90.00% and that of control group was 68.75%,the difference being statistically significant（ P 〈0.05）.After treatment,the APACHE II scores and MODS scores of observation group were（8.12±1.33）and（4.31±1.56）,respectively,and the APACHE II scores and MODS scores of control group were（12.46±1.87）and（6.44±1.93）,the difference being statistically significant（ P 〈0.05）.After treatment,high shear rate whole blood specific viscosity,serum specific viscosity and platelet adhesion rate of observation group were（5.37±0.16）map/s,（1.76±0.08）% and（34.57±15.68）%,respectively,all significantly lower than those of control group（ P 〈0.05）.The concentration of TNF-α,IL-6,IL-10 and CRP of observation group were（68.45±8.94）ng/mL,（67.24±8.58）ng/mL,（57.50±7.26）ng/mL and（69.37±9.23）mg/L after treatment,all significantly lower than those of control group（ P 〈0.05）. Conclusion CBP has good effects in the treatment of SAP complicated with MODS,which can effectively improve hemorheology,reduce serum inflammatory cytokines and prevent progression of the disease.
作者
李峰
Li Feng(Mianyang Third People′s Hospital,Mianyang,Sichuan 621000,China)
出处
《四川医学》
CAS
2018年第5期579-582,共4页
Sichuan Medical Journal
关键词
连续性血液净化
重症急性胰腺炎
多器官功能障碍
血液流变学
炎症因子
continuous blood purification
severe acute pancreatitis
multiple organ dysfunction
hemorheology
inflammatory cytokines
