摘要
目的 观察早期短时间床旁血液净化在急性胰腺炎治疗中的应用效果。方法 选取2016年12月至2021年12月安康市中心医院北院急诊医学科收治的90例急性胰腺炎患者纳入研究,按随机数表法分为观察组和对照组各45例。对照组患者给予常规治疗,观察组患者在对照组治疗的基础上使用早期短时间床旁血液净化治疗,两组均连续治疗一周。比较两组患者的短期预后、临床症状和住院时间,以及治疗前后的胃肠道功能、急性生理与慢性健康评分(APACHE Ⅱ)和血清指标。结果 观察组患者的膀胱压降至15 mmHg以下的时间和呼吸机使用时间分别为(6.12±1.33) d、(8.12±2.11) d,明显短于对照组的(8.34±1.24) d、(11.21±1.03) d,差异均有统计学意义(P<0.05);观察组患者的腹痛消失时间、肠鸣音恢复时间、住院时间分别为(4.31±1.01) d、(3.57±0.88) d和(14.32±2.25) d,明显快于对照组的(5.64±1.24) d、(5.06±1.35) d和(18.24±3.21) d,差异均有统计学意义(P<0.05);治疗后,两组患者的胃泌素(GAS)和血管活性肠肽(VIP)水平均较治疗降低,且观察组患者的GAS和VIP分别为(130.28±16.84)μmol/L、(5.23±1.27)μmol/L,明显低于对照组的(183.27±17.25)μmol/L、(6.38±1.33)μmol/L,差异均有统计学意义(P<0.05);治疗后,两组患者的胃动素(MOT)水平较治疗升高,且观察组患者的MOT为(226.23±14.77) ng/L,明显高于对照组的(173.52±14.34) ng/L,差异均有统计学意义(P<0.05);治疗后,两组患者的APACHEⅡ、血清总胆红素(TB)、血清淀粉酶(AMS)、C反应蛋白(CRP)均降低,且观察组患者分别为(7.34±2.11)分、(25.33±4.12)μmol/L、(412.33±71.17) U/L、(36.32±10.12) mg/L,明显低于对照组的(11.23±6.35)分、(32.58±4.33)μmol/L、(625.34±81.23) U/L、(72.33±11.23) mg/L,差异均有统计学意义(P<0.05)。结论 早期短时间床旁血液净化治疗急性胰腺炎能有效改善患者的短期预后,临床应用效果良好。
Objective To observe the application effect of early short-time bedside blood purification in the treatment of acute pancreatitis. Methods A total of 90 patients with acute pancreatitis who were admitted in the Department of Emergency Medicine, North Hospital, Ankang Central Hospital from December 2016 to December 2021 were selected and randomly divided into the observation group and the control group by random number table method, with45 cases in each group. Patients in the control group were given conventional treatment. On this basis, patients in the observation group were treated with early short-time bedside blood purification. Both groups were treated continuously for one week. The short-term prognosis, clinical symptoms, length of hospital stay, gastrointestinal function, the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) scores, and serum indexes in the two groups were comparatively analyzed. Results The time for bladder pressure to drop below 15 mmHg and the time of ventilator use in the observation group were(6.12±1.33) d and(8.12±2.11) d, respectively, which were significantly shorter than(8.34±1.24) d and(11.21±1.03) d in the control group(P<0.05). The disappearance time of abdominal pain, bowel sound recovery time,and length of hospital stay in the observation group were(4.31±1.01) d,(3.57±0.88) d, and(14.32±2.25) d, which were significantly shorter than(5.64±1.24) d,(5.06±1.35) d, and(18.24±3.21) d in the control group(P<0.05). After treatment, the levels of gastrin(GAS) and vasoactive intestinal peptide(VIP) were decreased in the two groups, and the levels in the observation group were(130.28±16.84) μmol/L and(5.23±1.27) μmol/L, significantly lower than(183.27±17.25) μmol/L and(6.38±1.33) μmol/L in the control group(P<0.05). Motilin(MOT) levels in the two groups were increased after treatment, and the level in the observation group was(226.23 ± 14.77) ng/L, significantly higher than(173.52±14.34) ng/L in the control group(P<0.05). After treatment, the APACHE Ⅱ scores, serum total bilirubin(TB),serum amylase(AMS), and C-reactive protein(CRP) levels were decreased in the two groups;these indicators in the observation group were(7.34±2.11) points,(25.33±4.12) μmol/L,(412.33±71.17) U/L, and(36.32±10.12) mg/L, which were significantly lower than(11.23±6.35) points,(32.58±4.33) μmol/L,(625.34±81.23) U/L, and(72.33±11.23) mg/L in the control group(P<0.05). Conclusion Early short-time bedside blood purification is effective in the treatment of acute pancreatitis, which can effectively improve the short-term prognosis.
作者
陈冬丽
李强
李维刚
CHEN Dong-li;LI Qiang;LI Wei-gang(Department of Emergency Medicine,North Hospital,Ankang Central Hospital,Ankang 725000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2023年第4期506-509,共4页
Hainan Medical Journal
基金
陕西省自然科学基金(编号:2017JM8084)。
关键词
血液净化
急性胰腺炎
胃肠道功能
胃泌素
血管活性肠肽
预后
Blood purification
Acute pancreatitis
Gastrointestinal function
Gastrin
Vasoactive intestinal peptide
Prognosis
