安徽医药
安徽醫藥
안휘의약
ANHUI MEDICAL AND PHARMACEUTICAL JOURNAL
2014年
11期
2087-2090,2091
,共5页
急性重症胰腺炎%连续性血液净化%血液滤过
急性重癥胰腺炎%連續性血液淨化%血液濾過
급성중증이선염%련속성혈액정화%혈액려과
severe acute pancreatitis%continuous blood purification%hemofiltration
目的：观察连续性血液净化(CBP)治疗重症急性胰腺炎(SAP)的效果，探讨提高SAP临床疗效的治疗措施。方法2009年1月-2012年12月期间在该院重症医学科收治的30例SAP患者随机均分为两组。观察两组患者生命体征、腹部体征，监测血液生化指标、炎症指标、氧合指数、APACHEⅡ、CT严重度指数( CTSI)，分析两组病死率。结果CBP组患者的体温、呼吸、心率、氧合恢复正常值所占比率较常规组升高；CBP组腹痛消失时间，腹胀缓解时间均较常规组缩短；CBP组氧合指数、肝肾功能较常规组改善；CBP组降钙素原、C反应蛋白、白细胞、血淀粉酶、APACHEⅡ评分及CTSI较常规组降低。 CBP组抢救成功率93%，病死率6.7%；常规组抢救成功率80%，病死率20%。结论 CBP改善和维持患者重要脏器功能，能有效救治临床并发症，降低病死率，改善SAP的预后。
目的：觀察連續性血液淨化(CBP)治療重癥急性胰腺炎(SAP)的效果，探討提高SAP臨床療效的治療措施。方法2009年1月-2012年12月期間在該院重癥醫學科收治的30例SAP患者隨機均分為兩組。觀察兩組患者生命體徵、腹部體徵，鑑測血液生化指標、炎癥指標、氧閤指數、APACHEⅡ、CT嚴重度指數( CTSI)，分析兩組病死率。結果CBP組患者的體溫、呼吸、心率、氧閤恢複正常值所佔比率較常規組升高；CBP組腹痛消失時間，腹脹緩解時間均較常規組縮短；CBP組氧閤指數、肝腎功能較常規組改善；CBP組降鈣素原、C反應蛋白、白細胞、血澱粉酶、APACHEⅡ評分及CTSI較常規組降低。 CBP組搶救成功率93%，病死率6.7%；常規組搶救成功率80%，病死率20%。結論 CBP改善和維持患者重要髒器功能，能有效救治臨床併髮癥，降低病死率，改善SAP的預後。
목적：관찰련속성혈액정화(CBP)치료중증급성이선염(SAP)적효과，탐토제고SAP림상료효적치료조시。방법2009년1월-2012년12월기간재해원중증의학과수치적30례SAP환자수궤균분위량조。관찰량조환자생명체정、복부체정，감측혈액생화지표、염증지표、양합지수、APACHEⅡ、CT엄중도지수( CTSI)，분석량조병사솔。결과CBP조환자적체온、호흡、심솔、양합회복정상치소점비솔교상규조승고；CBP조복통소실시간，복창완해시간균교상규조축단；CBP조양합지수、간신공능교상규조개선；CBP조강개소원、C반응단백、백세포、혈정분매、APACHEⅡ평분급CTSI교상규조강저。 CBP조창구성공솔93%，병사솔6.7%；상규조창구성공솔80%，병사솔20%。결론 CBP개선화유지환자중요장기공능，능유효구치림상병발증，강저병사솔，개선SAP적예후。
Objective To evaluate the efficacy of continuous blood purification in the treatment of severe acute pancreatitis and to ex-plore new methods for treatment of SAP. Methods Thirty SAP patients treated at Affiliated Anqing Hospital of Anhui Medical Univer-sity from January 2009 to December 2012 were randomly assigned into the conventional group(n=15) and the CBP group(n=15). Their viral signs,abdominal symptoms and signs were recorded. Blood biochemical parameters,inflammation markers,oxygenation in-dex,acute physiology and chronic health evaluation ( APACHEIIscore) and CT severity index were observed. The mortalities were an-alyzed . Results The APACHEII scores and CT severity index in the CBP group were significantly lower than those in the conventional group. The relief durations of abdominal pain and abdominal distension were significantly shortened in the CBP group. Compared with the conventional group, the serum amylase, white blood cell, C-reactive protein, procalcitonin were reduced significantly in the CBP group. Hepatic and renal function,oxygenation index were improved significantly in the CBP group. The success rate was 93% and the mortality was 6. 7% in the CBP group,while the success rate was 80% and the mortality was 20% in the conventional group. The mor-tality was significantly shortened in the CBP group. Conclusions CBP can improve and maintain the function of important organs in patients with SAP,significantly cut down mortality,treat clinical complications,and ameliorate the prognosis of SAP.
