中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (04): 234-237.doi: 10.3969/j.issn.1671-4091.2019.04.006

• 临床研究 • 上一篇    下一篇

短时连续床旁血液滤过治疗重症急性胰腺炎疗效评价

田甜1,胡文炜1,刘明浩1,李雪1,杜紫千1,王瑞玲1   

  1. 1中国人民解放军火箭军总医院消化内科
  • 收稿日期:2018-10-18 修回日期:2018-12-27 出版日期:2019-04-12 发布日期:2019-04-12
  • 通讯作者: 王瑞玲 wang.rui.lin.g@163.com E-mail:wang.rui.lin.g@163.com

Efficacy evaluation of short-term continuous renal replacement therapy in the treatment of severe acute pancreatitis

  • Received:2018-10-18 Revised:2018-12-27 Online:2019-04-12 Published:2019-04-12

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摘要： 【摘要】目的探讨短时连续床旁血液滤过治疗对重症急性胰腺炎的临床疗效。方法回顾性分析2010 年1 月～2018 年8 月收治的21 例重症急性胰腺炎患者的临床资料，对比入院后24h、48h(血液滤过前)及第7 日(血液滤过后)患者的监测指标变化和临床症状改善情况。结果对比入院后24～48h 各项指标：APACHE II 评分、腹痛等临床症状均有明显改善(t 值分别为4.249，2.439；P 值分别为＜0.001，0.019)，丙氨酸氨基转移酶、淀粉酶、脂肪酶、动脉血氧分压均明显下降(t/Z 值分别为3.384，-2.614，3.521，2.567；P 值分别为＜0.001，0.008，0.001，0.018)；C 反应蛋白明显升高(Z=-3.271，P=0.001)；白细胞、尿素氮、肌酐、三酰甘油、D-二聚体等对比无明显差异。对比血液滤过前后各项指标：APACHE II 评分、腹痛等临床症状均有明显改善(t 值分别为11.918，8.068；P 值分别为＜0.001，＜0.001)，C-反应蛋白、白细胞、丙氨酸氨基转移酶、肌酐、淀粉酶、动脉血氧分压明显改善(t/Z 值分别为-4.845，2.093，8.037，-4.076，-2.638，-3.602，P 值分别为＜0.001，0.049，＜0.001，＜0.001，0.008，0.001)，血液滤过治疗对尿素氮、脂肪酶、三酰甘油、D-二聚体等指标改善不明显。结论采取短时床旁血液滤过疗法可以迅速改善重症急性胰腺炎患者的临床症状及生化指标。

关键词: 重症急性胰腺炎, 短时连续床旁血液滤过, 疗效评价

Abstract: 【Abstract】Objective To investigate the clinical efficacy of short- term continuous renal replacement therapy (CRRT) early interventional therapy for severe acute pancreatitis (SAP). Methods Retrospective analysis of clinical data of 21 patients with severe acute pancreatitis admitted from January 2010 to August 2018, compared 24 hours、48 hours (before CRRT) and 7 days (after CRRT) after admission Changes in the patient's monitoring indicators and improvement in clinical symptoms. Results Comparing the indicators from 24 hours to 48 hours after admission: APACHE II score, abdominal pain and other clinical symptoms were significantly improved (t=4.249, 2.439 respectively; P＜0.001,P=0.019 respectively), alanine aminotransfer Enzyme, amylase, lipase, and arterial oxygen partial pressure were significantly decreased (t/z =3.384,- 2.614, 3.521 and 2.567 respectively;P＜0.001, 0.008, 0.001 and 0.018 respectively); C-reactive protein was significantly elevated (z=-3.271, P=0.001); There were no significant differences in white blood cells, urea nitrogen,
creatinine, triglyceride, and D-dimmer. Compared with the indexes before and after hemofiltration: APACHE II score, abdominal pain and other clinical symptoms were significantly improved (t=11.918, 8.068 respectively; P＜0.001,＜0.001 respectively), C-reactive protein, white blood cells, alanine Acid aminotransferase, creatinine, amylase, arterial oxygen partial pressure were significantly improved (t/z=-4.845,2.093,8.037,-4.076,- 2.638 and -3.602 respectively; P＜0.001, 0.049, ＜0.001, ＜0.001, 0.008 and 0.001 respectively), Hemofiltration treatment did not improve the indicators such as urea nitrogen, lipase, triglyceride, D-dimmer. Conclusion Short- term continuous renal replacement therapy can rapidly improve the clinical symptoms and biochemical
parameters of patients with severe acute pancreatitis.

Key words: Severe acute pancreatitis, Continuous renal replacement therapy, Efficacy evaluation