bbad血液滤过对急性重症胰腺炎的疗效观察.pdfVIP

·34· 连续血液滤过对急性重症胰腺炎的疗效观察 刘虹雯李乾静宋锐锋 【摘要】 目的探讨连续性静脉一静脉血液滤过(CVVH)治疗重症急性胰腺炎(SAP)的效果。方法 对20例采用CVVH治疗的SAP患者的细胞因子测定、部分生化指标、APACHEII评分等资料进行回顾 性分析。结果应用CVVH后，患者体温、腹胀、腹痛等症状明显减轻，APACHEII评分明显下降，血中 TNF．0【、IL一8明显减少，K+、Cr有明显的改善，尤以治疗后24h为著，并能维持血流动力学的稳定。结论 CVVH在重症急性胰腺炎早期治疗时可以显著改善患者的各项指标及临床症状。 【关键词】 连续性血液净化；重症急性胰腺炎 Effectofcontinuousveno-venoushemofiltrationintreatmentofsevereacute L／U pancreatitisHong— wen，LIQian-jing，SONGRui垂ng．Departmentofgastroenterology，the∥rstpeople’5hospitalofshangqiu，Henan， 476000．C^ina Shangqiu To theeffectofcontinuousyeno—venous 【Abstract】0bjectiveexplore hemofihration(CVVH)onpa— tientswithsevereacute withsevereacute weretrea． pancreatitis(SAP)．MethodsTwentypatients pancreatitis tedwithCVVH．Theirclinicaldata cell of index、APACHEIIscore includinggenemensuration、partbiochemistry etcwere A11 andabdominal were analysed．Resultspatients’temperaturedistention、bellyacheevidentlyeasely the treat inbloodwere werealso tosomeextent．Ex． afterCVVHment，TNF．d、IL．8 declined，K+、Cr improved of The CVVH aftertreated24hours．Thesteadiness wasmaintainable．Conclusion actly haemodynamics early treatmentin withSAPcouldalleviateclinical inacutereactive patients signobviously period． Continuousveno-venous acute hemofileration；Ssevere 【Keywords】 pancreatitis 急性胰腺炎(acutepancreatitis，AP)是临床常见多发病， 临床表现为来势凶猛的急腹症，并发症多，特别是重症急性 胰腺炎(severeacutepancreatitis，SAP)死亡率高达20％～高脂饮食9例，妊娠1例。合并症：全身炎症反应综合征 30％…。随着医学的进步，重症急性胰腺炎的非手术治