CAJ | 학술논문

目的：探讨不同血液净化方式治疗重症胰腺炎致全身炎性反应综合征患者的临床疗效。方法选取2011年6月至2013年5月我院收治的重症胰腺炎致全身炎性反应综合征患者60例进行分析，按照治疗方法分成观察组和对照组各30例，观察组采用高流量连续血液净化，对照组采用常规血液净化，观察两组治疗前后APACHEII评分、MARSHALL评分、细胞因子变化以及机械通气时间、病死率。结果两组治疗后患者的APACHEII评分和MARSHALL评分均有显著下降（P＜0.05），且观察组下降水平明显优于对照组（P＜0.05）；两组治疗后IL-6、IL-10、TNFα较治疗前均有明显下降（P＜0.05），且观察组下降水平明显优于对照组（P＜0.05）；观察组机械通气时间明显少于对照组（P＜0.05），病死率明显低于对照组（P＜0.05）。结论采用高流量连续血液净化治疗重症胰腺炎致全身炎性反应综合征，能够改善患者的机体状况，清除非特异性细胞因子，降低患者病死率。
목적：탐토불동혈액정화방식치료중증이선염치전신염성반응종합정환자적림상료효。방법선취2011년6월지2013년5월아원수치적중증이선염치전신염성반응종합정환자60례진행분석，안조치료방법분성관찰조화대조조각30례，관찰조채용고류량련속혈액정화，대조조채용상규혈액정화，관찰량조치료전후APACHEII평분、MARSHALL평분、세포인자변화이급궤계통기시간、병사솔。결과량조치료후환자적APACHEII평분화MARSHALL평분균유현저하강（P＜0.05），차관찰조하강수평명현우우대조조（P＜0.05）；량조치료후IL-6、IL-10、TNFα교치료전균유명현하강（P＜0.05），차관찰조하강수평명현우우대조조（P＜0.05）；관찰조궤계통기시간명현소우대조조（P＜0.05），병사솔명현저우대조조（P＜0.05）。결론채용고류량련속혈액정화치료중증이선염치전신염성반응종합정，능구개선환자적궤체상황，청제비특이성세포인자，강저환자병사솔。
ObjectiveTo investigate the clinical effi cacy of the different blood purifi cation treatment in patients with severe pancreatitis-induced systemic inflammatory response syndrome.Methods The data of 60 patients with severe pancreatitis induced systemic inflammatory response syndrome selected from June 2011 to May 2013 in our hospital, were analyzed according to the treatment methods and divided into observation group and control group (30 patients each). The patients in observation group were treated with high fl ow continuous blood purifi cation, while conventional blood purifi cation was used in the control group. APACHEII score, MARSHALL score, cytokines and mechanical ventilation and mortality were observed before and after treatment.Results After treatment, the patient's MARSHALL score and APACHEII scores were signifi cantly decreased (P <0.05) and the level of reduction in the observation group was signifi cantly more than that in the control group (P <0.05). The level of IL-6, IL-10 and TNFα after treatment were signifi cantly decreased compared with that before treatment (P <0.05), and the levels of reduction in the observation group were signifi cantly more than that in the control group (P <0.05). The mechanical ventilation time in the observation group was signifi cantly less than that in the control group (P <0.05) and the mortality was signifi cantly lower than that in the control group (P <0.05).Conclusion The high-fl ow continuous blood purifi cation treatment of severe pancreatitis-induced systemic infl ammatory response syndrome, can improve the body condition of the patients, remove non-specifi c cytokines and reduce patients’ mortality.