CRRT介入时机与重症急性胰腺炎疗效评价

发布时间：2018-05-29 21:28

  本文选题：持续性肾替代治疗 + 重症急性胰腺炎　； 参考：《浙江大学》2017年硕士论文

【摘要】：目的:观察不同时机使用连续性肾替代治疗(continuous renal replacement treat ment,CRRT)在重症急性胰腺炎(sever acute pancreatitis,SAP)治疗效果。方法:回顾2015年1月至2016年12月入住浙江大学医学院附属邵逸夫医院重症医学科(4F)46例符合中华医学会胰腺外科组SAP诊断及分级标准且均接受CRRT治疗的患者的临床资料,分为早期治疗组(A组)和晚期治疗组(B组),均采用常规治疗+CRRT。A组为一旦诊断明确为SAP即行CRRT,B组为出现急性肾损伤再行CRRT,统计分析两组间的生命体征、实验室指标、(sequential organ failure assessment,SOFA)SOFA 评分、(acute disease physiology and chronic health evaluation Ⅱ,APACHE Ⅱ)APACHE Ⅱ 评分、(modified CT severity index,MCTSI)MCTSI评分、28天死亡率、机械通气时间等指标分析CRRT介入时机与重症急性胰腺炎患者预后的相关性。结果:A组与B组治疗前的C-反应蛋白比较(79.86±14.57 vs 84.47±12.23)、腹内压比较(14.3±4.16vs13.69±4.23)、APACHEⅡ 评分(13.82±3.44vs16.00±3.94)、SOFA评分(6.69±2.77vs8.34±2.88)等无统计学差异(P0.05);A组与B组治疗后的比较C-反应蛋白比较(14.6±4.84 vs 17.73±5.42)、腹内压比较(9.34±1.61 vs 10.60±1.97)、APACHE Ⅱ 评分(5.43±1.82vs9.78±2.67)、SOFA 评分(5.43±1.82 vs9.78±2.67)、机械通气时间比较(7.82±1.85vs9.60±2.79)、28 天死亡率(4.35%vs13.04%)、总住院时间(25.21±7.68vs29.91±6.86)均有统计学差异(P0.05)。结论:早期行CRRT治疗,可以降低SAP患者28天死亡率,减少住院时间。
[Abstract]:Objective: to observe the effect of continuous renal replacement treat replacement therapy (CRRT) in the treatment of severe acute pancreatitis (SAP). Methods: from January 2015 to December 2016, we reviewed the clinical data of 46 patients admitted to the Department of intensive Medicine of run Shaw Hospital affiliated to Zhejiang University Medical College from January 2015 to December 2016, who met the criteria of SAP diagnosis and grading in the pancreatic surgery group of the Chinese Medical Association and were treated with CRRT. The patients were divided into early treatment group (group A) and late treatment group (group B). Routine treatment of CRRT.A group was performed as soon as the diagnosis of SAP was confirmed, and then the occurrence of acute renal injury was performed in group B. The vital signs between the two groups were analyzed statistically. The laboratory parameters such as sequential organ failure assessment of SOFAFA score and acute disease physiology and chronic health evaluation 鈪，

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