连续血液滤过对重症急性胰腺炎的治疗作用.DOCVIP

临床医学论文-连续血液滤过对重症急性胰腺炎的治疗作用 ???????? 作者：陈嘉屿，张方信，吴红梅，刘丽华，赵丽 【关键词】? 血液滤过；急性病；胰腺炎 　　Curative effect of continuous venovenous hemofiltration in patients with severe acute pancreatitis?　　【Abstract】 AIM: To observe the treatment effect of continuous venovenous hemofiltration (CVVH) in patients with severe acute pancreatitis(SAP). METHODS: Twentysix SAP patients were randomly divided into 2 groups: CVVH group (A, n=11) and control group (B, n=15). Both of group A and B were treated with conventional therapy, while the patients in group A additionally underwent CVVH. Heart rate (HR), respiration(R), blood pressure (BP), functions of liver, kidney and gastrointestine were observed. PO2/FiO2, SaO2, plasma levels of electrolyte and glucose, Creactive protein (CRP) and blood routine were determined. APACHEⅡ scores were used to evaluate the patients conditions. RESULTS: White blood cell(WBC), plasma levels of glucose and calcium were improved in group A and B 24 h after treatment (P0.05). Group A was better than group B in terms of the functions of liver, kidney and APACHEⅡ scores (P0.05). Seven days later, CRP was decreased in both A and B (P0.05), but more distinctly in group A (P0.05). B was also improved in the functions of liver, kidney and APACHEⅡ scores (P0.05). The incidences of acute lung injury and complications were reduced significantly in the 2 groups (P0.05). The hydrocele was removed rapidly in both chest and abdomen and the incidence of complications was decreased (P0.05). CONCLUSION: CVVH may correct the liver and renal dysfunctions that were brought out by SAP, improve physical conditions, and prevent efficiently the complications.? 　　【Keywords】 hemofiltration;? acute disease; pancreatitis 　　【摘要】 目的： 观察连续血液滤过对重症急性胰腺炎的治疗作用. 方法： 26例重症急性胰腺炎患者分为2组： 连续血液滤过组（A组，n=11）和对照组（B组，n=15）. 在用常规治疗的基础上，A组加用连续血液滤过. 观察两组患者的心率、呼吸、血压、肝、肾功能及胃肠功能指标；氧合指数（PO2/FiO2）、血氧饱和度（SaO2）；血浆电解质、葡萄糖、血常规以及C反应蛋白；并行APACHEⅡ评分. 结果： 治疗后24 h, A，B两组白细胞、血糖、血钙水平均明显好转（P0.05），A组肝肾功能指标、APACHEⅡ积分与B组比较显著改善(P0