联合血液净化治疗对重症急性胰腺炎患者炎症因子和疗效的影响

发布时间：2018-05-29 02:07

  本文选题：血液净化 + 血液滤过　； 参考：《重庆医学》2015年18期

【摘要】：目的探讨联合血液净化(CBP)治疗对重症急性胰腺炎(SAP)患者炎症因子和疗效的影响。方法 82例SAP患者分为对照组42例和CBP组40例,对照组采用常规综合治疗方法,CBP组在对照组治疗基础上加用血液滤过联合血液灌流治疗。比较两组患者治疗前及治疗72h后生命体征、炎症因子、急性生理学与慢性健康状况评分(APACHEⅡ评分)变化;记录两组患者临床症状如腹胀、腹痛等消失的时间、体温恢复时间、肠蠕动恢复时间、血淀粉酶恢复时间、住院时间及血液净化过程中出现的不良反应。结果治疗72h后两组患者的生命体征(T、HR、RR、MAP)、OI、TG及炎症因子水平(TNF-α、IL-6、hs-CRP、PCT)均较治疗前有显著改善(P0.05),而CBP组患者MAP、OI、TG及炎症因子水平(TNF-α、IL-6、hs-CRP、PCT)较对照组改善更显著(P0.01);CBP组的症状消失时间、体温恢复时间、肠蠕动恢复时间、血淀粉酶恢复时间及住院时间均明显短于对照组(P0.01);CBP组的治愈率高于对照组(P0.05),病死率低于对照组(P0.05);CBP的不良反应轻微。结论在常规综合治疗基础上,CBP治疗能更有效地提高OI和APACHEⅡ评分,加快病情恢复,缩短住院时间,其机制可能与更有效地清除体内炎症介质和血脂有关。
[Abstract]:Objective to investigate the effect of combined blood purification therapy (CBP) on inflammatory factors in patients with severe acute pancreatitis (SAP). Methods Eighty-two patients with SAP were divided into control group (n = 42) and CBP group (n = 40). The changes of vital signs, inflammatory factors, acute physiology and chronic health status were compared before and 72 hours after treatment, and the clinical symptoms such as abdominal distension and abdominal pain were recorded, and the recovery time of body temperature was recorded. Intestinal peristalsis recovery time, blood amylase recovery time, hospitalization time and adverse reactions during blood purification. Results after 72 hours of treatment, the vital signs and the levels of TNF- 伪 IL-6hs-CRPnc-PCT in the two groups were significantly improved compared with those before treatment, while in the CBP group, the levels of TNF- 伪 IL-6hs-CRPPCT were improved more significantly than those of the control group, and the time of disappearance of symptoms and the time of recovery of body temperature were significantly improved compared with those of the control group, while the levels of TNF- 伪 IL-6hs-CRPPnhs-CRPPCT in the CBP group were significantly improved compared with those in the control group, and the recovery time of body temperature in the two groups was much higher than that in the control group, and that in the CBP group was significantly higher than that in the control group. The recovery time of intestinal peristalsis, the recovery time of blood amylase and the time of hospitalization were significantly shorter than those of the control group (P 0.01). The cure rate of CBP group was higher than that of control group (P 0.05), and the fatality rate was lower than that of control group (P 0.05). Conclusion on the basis of routine comprehensive therapy, CBP can effectively improve the scores of OI and APACHE 鈪，

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