宣白承气汤与芒硝联合脉冲式高容量血液滤过治疗重症急性胰腺炎患者的临床观察

发布时间：2018-01-11 05:27

本文关键词：宣白承气汤与芒硝联合脉冲式高容量血液滤过治疗重症急性胰腺炎患者的临床观察　出处：《中华医院感染学杂志》2016年13期 　论文类型：期刊论文

【摘要】：目的探讨宣白承气汤、芒硝联合脉冲式高容量血液滤过(PHVHF)治疗重症急性胰腺炎(SAP)的疗效,为临床治疗SAP提供参考。方法选择2015年1月-2015年10月于医院重症医学科收治13例SAP患者为研究对象,在接受常规西医治疗基础上,给予芒硝外敷,宣白承气汤灌肠,并联合PHVHF治疗,观察治疗前后患者的生命体征、腹部症状、血生化指标、血气分析、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分及Ranson评分的变化情况及预后。结果患者治疗前后,体温、心率和呼吸频率等较治疗前均明显缓解,差异有统计学意义(P0.05);存活12例患者,血流动力学均稳定,平均动脉压(42±3)和(74±7)mmHg较治疗前明显上升(P0.05)。患者治疗前后,丙氨酸转氨酶、血清淀粉酶和总胆红素等较治疗前均明显下降,差异有统计学意义(P0.05);治疗前后,动脉血氧分压、动脉血二氧化碳分压和氧合指数较治疗前均明显升高,差异有统计学意义(P0.05)。结论宣白承气汤与芒硝联合PHVHF治疗重症急性胰腺炎临床效果显著,可作为SAP治疗的方法之一。
[Abstract]:Objective to investigate Xuanbai Chengqi Decoction Combined with mirabilite, pulsed high volume hemofiltration (PHVHF) treatment of severe acute pancreatitis (SAP) curative effect, to provide reference for clinical treatment of SAP. Methods from January 2015 -2015 year in October in the ICU hospital treated 13 cases of SAP patients as the research object, based on accepting the conventional Western medical treatment give, mirabilite, Xuanbai Chengqi Decoction, and combined with PHVHF treatment, vital signs were observed before and after treatment of abdominal symptoms, blood biochemical index, blood gas analysis, and chronic health evaluation II (APACHE II) acute physiology changes and prognostic score and Ranson score. Results the patients before and after treatment. The body temperature, heart rate and respiratory rate than before treatment were significantly alleviated, the difference was statistically significant (P0.05); 12 cases of survival patients, hemodynamics were stable, mean arterial pressure (42 + 3) and (74 + 7) mmHg than before treatment significantly Rose (P0.05). The patients before and after treatment, alanine aminotransferase, serum amylase and total bilirubin decreased significantly, the difference was statistically significant (P0.05); before and after the treatment, PaO2, PaCO2 and oxygenation index were significantly higher than that before treatment, the difference was statistically significant (P0.05) conclusion Xuanbai bearing clinical effect of Qi Decoction with mirabilite combined with PHVHF in treatment of severe acute pancreatitis was one of the methods can be used in treatment of SAP.

【作者单位】：河南中医学院第一附属医院重症医学科;
【基金】：2014年度河南省中医药科学研究专项课题(2014ZY02029)
【分类号】：R576
【正文快照】： 重症急性胰腺炎(SAP)除局部病理表征之外,通常合并全身炎症反应综合征(SIRS),SAP其病因复杂,病情变化多端,常伴有多器官功能障碍综合征(MODS),病死率高[1-2]。迄今为止,仍无特效药物用于SAP的治疗,单纯的西医治疗和手术方式已经无法有效控制SAP,目前一般采用综合性治疗方案[3]

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