全科医学临床与教育
全科醫學臨床與教育
전과의학림상여교육
CLINICAL EDUCATION OF GENERAL PRACTICE
2013年
4期
385-387,390
,共4页
血浆置换%连续性血液净化%妊娠%胰腺炎%高脂血症
血漿置換%連續性血液淨化%妊娠%胰腺炎%高脂血癥
혈장치환%련속성혈액정화%임신%이선염%고지혈증
plasma exchange%continuous renal replacement%pregnancy%pancreatitis%pyperlipemia
目的探讨血浆置换联合连续性血液净化治疗妊娠合并高脂血症性急性重症胰腺炎的疗效。方法回顾29例妊娠合并高脂血症性急性重症胰腺炎患者资料，按收治时间分组：对照组（n=11）行传统的胰腺炎治疗，治疗组（n=18）在传统治疗同时行血浆置换联合连续性血液净化治疗，观察两组患者治疗前后48 h急性生理和慢性健康评价指标Ⅱ（APACHEⅡ）评分、禁食天数、住院天数、治疗前后血清甘油三酯、总胆固醇水平。结果治疗组治疗48 h后APACHEⅡ评分明显低于对照组，禁食天数及住院天数明显少于对照组，差异均有统计学意义（t分别=3.61、4.58、3.95，P均＜0.05）；治疗组甘油三酯及总胆固醇水平治疗6 d后均明显低于对照组，差异均有统计学意义（t分别=3.16、4.16，P均＜0.05）；两组治疗后血清甘油三酯、总胆固醇水平较治疗前均降低，差异均有统计学意义（t分别=5.12、6.02、3.12、3.02，P均＜0.05）；治疗组无产妇死亡；对照组1例产妇死亡，死于感染并发多脏器功能衰竭。结论血浆置换联合连续性血液净化可以迅速降低甘油三酯及总胆固醇，是治疗妊娠并高脂血症性急性重症胰腺炎安全而有效的方法之一。
目的探討血漿置換聯閤連續性血液淨化治療妊娠閤併高脂血癥性急性重癥胰腺炎的療效。方法迴顧29例妊娠閤併高脂血癥性急性重癥胰腺炎患者資料，按收治時間分組：對照組（n=11）行傳統的胰腺炎治療，治療組（n=18）在傳統治療同時行血漿置換聯閤連續性血液淨化治療，觀察兩組患者治療前後48 h急性生理和慢性健康評價指標Ⅱ（APACHEⅡ）評分、禁食天數、住院天數、治療前後血清甘油三酯、總膽固醇水平。結果治療組治療48 h後APACHEⅡ評分明顯低于對照組，禁食天數及住院天數明顯少于對照組，差異均有統計學意義（t分彆=3.61、4.58、3.95，P均＜0.05）；治療組甘油三酯及總膽固醇水平治療6 d後均明顯低于對照組，差異均有統計學意義（t分彆=3.16、4.16，P均＜0.05）；兩組治療後血清甘油三酯、總膽固醇水平較治療前均降低，差異均有統計學意義（t分彆=5.12、6.02、3.12、3.02，P均＜0.05）；治療組無產婦死亡；對照組1例產婦死亡，死于感染併髮多髒器功能衰竭。結論血漿置換聯閤連續性血液淨化可以迅速降低甘油三酯及總膽固醇，是治療妊娠併高脂血癥性急性重癥胰腺炎安全而有效的方法之一。
목적탐토혈장치환연합련속성혈액정화치료임신합병고지혈증성급성중증이선염적료효。방법회고29례임신합병고지혈증성급성중증이선염환자자료，안수치시간분조：대조조（n=11）행전통적이선염치료，치료조（n=18）재전통치료동시행혈장치환연합련속성혈액정화치료，관찰량조환자치료전후48 h급성생리화만성건강평개지표Ⅱ（APACHEⅡ）평분、금식천수、주원천수、치료전후혈청감유삼지、총담고순수평。결과치료조치료48 h후APACHEⅡ평분명현저우대조조，금식천수급주원천수명현소우대조조，차이균유통계학의의（t분별=3.61、4.58、3.95，P균＜0.05）；치료조감유삼지급총담고순수평치료6 d후균명현저우대조조，차이균유통계학의의（t분별=3.16、4.16，P균＜0.05）；량조치료후혈청감유삼지、총담고순수평교치료전균강저，차이균유통계학의의（t분별=5.12、6.02、3.12、3.02，P균＜0.05）；치료조무산부사망；대조조1례산부사망，사우감염병발다장기공능쇠갈。결론혈장치환연합련속성혈액정화가이신속강저감유삼지급총담고순，시치료임신병고지혈증성급성중증이선염안전이유효적방법지일。
Objective To observe the effect of therapeutic plasma exchange (PE) combined with continuous renal re-placement therapy (CRRT) in treatment of gestational hyperlipidemia acute severe pancreatitis. Methods A total of 29 cases of gestational hyperlipidemia acute severe pancreatitis patients were divided into two groups. The control group with 11 cases accepted the traditional treatment while the treatment group with 18 cases accepted PE combined with CRRT based on the traditional treatment. The acute physiology and chronic health evaluation score, days of abrosia and hospital-ization, and the level of plasma triglyceride(TG) and total cholesterol(TC) at 48 hours after postoperative were compared. Results The score of APACHE, days of abrosia and hospitalization of the treatment group were significantly fewer than the control group (t=3.61,4.58,3.95,P<0.05). The levels of TG and TC of the treatment group were significantly lower than the control group at 6 days after postoperative (t=3.16, 4.16, P<0.05). The levels of TG and TC of two groups were significantly decreased after therapy (t=5.12, 6.02, 3.12, 3.02, P<0.05). One patient in the control group died of multi-ple organs failure induced by infection while none of treatment group was died. Conclusions PE combined with CRRT treatment can quickly reduce TG and TC levels. It’s a safe and effective way to cure gestational hyperlipidemia acute se-vere pancreatitis.
