配对血浆滤过吸附治疗重症急性胰腺炎的随机对照研究

发布时间：2018-02-14 12:42

  本文关键词： 配对血浆分离吸附法 连续性血液净化 重症急性胰腺炎　出处：《中山大学学报(医学科学版)》2015年06期 　论文类型：期刊论文

【摘要】：【目的】观察配对血浆分离吸附法(CPFA)对重症急性胰腺炎(SAP)患者病情发展的影响、临床疗效和安全性,并探讨其治疗机制。【方法】将30例重症急性胰腺炎(SAP)患者随机分为两组,治疗组15例采用CPFA技术治疗,对照组15例采用常规连续性静脉-静脉血液滤过(CVVH)治疗,所有患者均在ICU监护中,30例患者比较治疗过程的平均动脉压、Pa O2/Fi O2、TNF-α、IL-1β、IL-6、IL-10、肝肾功能生化指标、血、尿淀粉酶、临床改善程度以及APACHEⅡ评分的改善,同时观察治疗的副作用,同时随访病人的预后,统计分析其存活率。【结果】两组间治疗前病情的严重程度基本无差异(P0.05),CPFA治疗组患者在治疗平均动脉压、Pa O2/Fi O2明显上升(P0.05),促炎症因子TNF-α、IL-1β、IL-6等因子明显降低(P0.05),抗炎症因子IL-10增加(P0.05),与对照组相比均有统计学差异(P0.05),治疗组治疗后APACHEⅡ评分呈下降趋势,至第10天明显低于治疗前和对照组(P0.05),治疗组未发生休克、出血、过敏等严重并发症,耐受好,并发症的发生率无统计学差异(与对照组相比);治疗组存活率12/15(80%)明显高于对照组7/15(46.7%;P0.05)。【结论】CPFA可有效调整机体的免疫功能,改善重症急性胰腺炎患者的预后,提高存活率,而且无明显不良反应,值得在临床上推广。
[Abstract]:[objective] to observe the effect, clinical efficacy and safety of paired plasma separation and adsorption (CPFAA) on the development of severe acute pancreatitis (SAP) patients, and to explore its therapeutic mechanism. [methods] Thirty patients with severe acute pancreatitis (SAP) were randomly divided into two groups. 15 patients in the treatment group were treated with CPFA technique, and 15 patients in the control group were treated with routine continuous veno-venous hemofiltration (CVVH). 30 patients in ICU monitoring were compared with the mean arterial pressure Pa O 2 / fi O 2, TNF- 伪 IL-1 尾 and IL-6 IL-10, and the biochemical indexes of liver and kidney function. Blood, urine amylase, clinical improvement and APACHE 鈪，

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