连续肾脏替代疗法治疗急性重症胰腺炎合并急性肾功能衰竭临床研究.docVIP

连续肾脏替代疗法治疗急性重症胰腺炎合并急性肾功能衰竭临床研究 　　[摘要] 目的 探讨急性重症胰腺炎（SAP）合并急性肾功能衰竭（ARF）应用连续肾脏替代疗法（CRRT）治疗的临床疗效。 方法 方便选取该院于2014年2月―2016年2月期间收治的SAP合并ARF患者40例，按数字随机法分组：治疗组（n=20）给予连续肾脏替代疗法治疗，对照组（n=20）给予传统血液透析治疗，比较两组治疗效果、治疗96 h后的APACHEⅡ评分、血清Cr、Lac、CRP水平，并记录两组肾上腺素使用率、28 d死亡率以及24 h尿量。 结果 治疗组的总有效率为95.00%，与对照组的85.00%比较差异有统计学意义（P0.05）；治疗组治疗96 h后的APACHEⅡ评分为（17.34±6.05）分，较对照组的（19.01±5.23）分显著降低（P0.05）；治疗组治疗96 h后的血清Cr、Lac、CRP水平分别为（196.87±33.41）umol/L、（53.27±8.52）mg/L）、（3.04±1.13）mmol/L，均较治疗前和对照组显著降低（P0.05）；治疗组肾上腺素使用率和28 d死亡率分别为30.00%、10.00%，均较对照组的55.00%/45.00%显著降低（P0.05）；治疗组治疗后的24 h尿量为（1273.35±102.02）mL，显著高于对照组的（1210.87±67.88）mL（P0.05）。结论 连续肾脏替代疗法治疗SAP合并ARF疗效确切，可有效改善血清炎症因子水平，降低病死率。 　　[关键词] 急性重症胰腺炎；急性肾功能衰竭；连续肾脏替代疗法；临床疗效 　　[中图分类号] R657 [文献标识码] A [文章编号] 1674-0742（2016）07（b）-0006-04 　　Clinical Study of Continuous RenalRreplacement Therapy in the Treatment of Acute Severe Acute Pancreatitis Complicated with Acute Renal Failure 　　CHAO Li 　　Municiple Hospital blood purification center in Heze of Shandong， Heze， Shandong Province， 274000 China 　　[Abstract] Objective To investigate the clinical effect of continuous renal replacement therapy （CRRT） in the treatment of severe acute pancreatitis （SAP） complicated with acute renal failure （ARF）. Methods Selected in our hospital from February 2014 February 2016 treated SAP complicated with ARF patients and 40 cases， grouped by randomly： treatment group （n = 20） given continuous renal replacement therapy， control group （n = 20） was treated with conventional hemodialysis treatment， compared two groups of patients with therapeutic effects of the two groups were compared， the APACHE II score， serum Cr， Lac and CRP levels were compared between the groups. The rates of epinephrine use， 28d mortality rate， and the amount of 24h in the two groups were recorded. Results The total efficiency of the treatment group was 95%， and 85% in the control group had significant difference （P 　　[Key words] Acute severe acute pancreatitis； Acute renal failure； Continuous re