摘要
目的探讨连续性血液净化治疗中重度急性胰腺炎的临床疗效。方法回顾性分析商丘市第一人民医院2018年1月至2019年10月收治的中重度急性胰腺炎患者94例的临床资料,按照治疗方法不同分为对照组47例、观察组47例,对照组采用常规治疗,观察组在常规治疗基础上联合连续性血液净化治疗。比较两组入院72 h后腹痛、腹胀缓解情况,呼吸、心率等生命体征的变化,肝酶、肾功能、C反应蛋白(CRP)、白细胞介素6(IL-6)、全身炎症反应综合征(SIRS)中位缓解时间,急性生理和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、改良Marshll评分、改良CT严重指数 (MCTSI)评分的变化。结果观察组腹痛缓解时间[(2.28±0.44)d]、SIRS中位缓解时间[(5.27±0.95)d]均明显短于对照组的(6.23±1.01)d、(11.30±1.12)d,差异均有统计学意义(t=34.213、28.308,均P<0.05);观察组丙氨酸氨基转移酶、血尿素氮、血肌酐、CRP、IL-6分别为(28.22±34.38)U/L、(5.73±1.83)mmol /L、(70.26±4.34)μmol/L、(102.66±3.29)mg/L、(110.45±5.50)pg/L,均明显低于对照组的(47.26±56.61)U/L、(10.55±3.09)mmol /L、(114.21±6.87)μmol/L、(210.51±10.11)mg/L、(281.77±14.99)pg/L(t=3.520、23.724、81.266、96.618、114.005,均P<0.05);观察组APACHEⅡ评分、改良Marshll评分、MCTSI评分分别为(11.43±0.66)分、(3.06±0.29)分、(8.16±0.27)分,均低于对照组的(18.49±1.77)分、(4.92±0.37)分、(9.57±0.35)分,差异均有统计学意义(t=39.590、76.458、67.484,均P<0.05)。结论连续性血液净化治疗能有效清除体内代谢产物和毒物,缩短SIRS持续时间,促进机体功能恢复,从而改善中重度急性胰腺炎患者的预后。
Objective To investigate the curative effects of early continuous blood purification therapy on moderate to severe acute pancreatitis.Methods The clinical data of 94 patients with moderate to severe acute pancreatitis who received treatment in the First People's Hospital of Shangqiu,China between January 2018 and October 2019 were retrospectively analyzed.These patients were divided into a control group and an observation group(n=47/group)according to different treatment methods.The control group was treated with conventional treatment,while the observation group was treated with continuous blood purification therapy based on conventional treatment.The time to abdominal pain and distension relief,the changes of vital signs such as respiration and heart rate,renal function,the levels of liver enzymes,C-reactive protein and interleukin-6,median remission time of systemic inflammatory response syndrome,the Acute Physiology,Age,Chronic Health Evaluation II score,modified Marshall score,and modified CT severity index(MCTSI)were compared between the two groups.Results The time to abdominal pain relief[(2.28±0.44)d]and the median remission time of systemic inflammatory syndrome[(5.27±0.95)d]were significantly shorter than those in the control group[(6.23±1.01)d and(11.30±1.12)d,t=34.213 and 28.308,both P<0.05].The levels of alanine aminotransferase,blood urea nitrogen,serum creatinine,C-reactive protein and interleukin-6 in the observation group were(28.22±34.38)U/L,(5.73±1.83)mmol/L,(70.26±4.34)μmol/L,(102.66±3.29)mg/L,(110.45±5.50)pg/L respectively,which were significantly lower than those in the control group[(47.26±56.61)U/L,(10.55±3.09)mmol/L,(114.21±6.87)μmol/L,(210.51±10.11)mg/L,(281.77±14.99)pg/L,t=3.520,23.724,81.266,96.618,114.005,all P<0.05].The Acute Physiology,Age,Chronic Health Evaluation II score,modified Marshall score,and modified CT severity index in the observation group were(11.43±0.66)points,(3.06±0.29)points,(8.16±0.27)points,which were significantly lower than(18.49±1.77)points,(4.92±0.37)points,(9.57±0.35)points respectively in the control group(t=39.590,76.458,67.484,all P<0.05).Conclusion Continuous blood purification therapy can effectively remove metabolites and poisons from the body,shorten the duration of systemic inflammatory response syndrome,promote the recovery of body function,and thereby improve the prognosis of moderate to severe acute pancreatitis.
作者
屠淑敏
Tu Shumin(Department of Emergency,the First People's Hospital of Shangqiu,Shangqiu 476100,Henan Province,China)
出处
《中国基层医药》
CAS
2021年第5期728-732,共5页
Chinese Journal of Primary Medicine and Pharmacy
