连续性血液净化对老年重症急性胰腺炎的临床治疗与观察  

Continuous blood purification in clinical treatment and observation of elderly patients with severe acute pancreatitis

作　　者：于颖[1] 孟建中[1] 赵雷[2] 吕苏一[1] 岳冀[1] 

机构地区：[1]济南军区总医院血液净化科,山东济南250031 [2]济南军区总医院肝胆外科,山东济南250031

出　　处：《中国现代医学杂志》2011年第5期641-644,共4页China Journal of Modern Medicine

摘　　要：目的研究连续性血液净化(continuous blood purification,CBP)治疗在老年重症急性胰腺炎(severeacute pancreatitis,SAP)中的治疗效果。方法全组47例老年SAP患者接受了CBP治疗,在CBP治疗前和治疗后12 h及24h,对患者进行血液生化学指标、血常规、血淀粉酶、C反应蛋白和血气分析检测,同时记录患者的心率(HR)、平均动脉(MAP)、中心静脉压(CVP)、血氧饱和度、呼吸频率、体温等,采用APACHEⅡ、SAPSⅡ和MCDS评分。结果治疗后患者的血肌酐、血淀粉酶和C反应蛋白均明显低于治疗前,47例SAP患者中39例治愈(存活率为87.22%),8例死亡(死亡率为12.78%)。结论 CBP治疗对老年重症SAP有明显的效果,能有效地防治并发症,降低死亡率。【Objective】 To investigate the mechanism of CBP in the treatment of severe acute pancreatitis.【Methods】 Forty-seven of SAP patients received CBP old age therapy.The blood routine test,blood biochemistry indexes and blood-gas analysis before the start of CBP and after CBP for 12,24 hours were examined and noted.Meanwhile,APACHEⅡ,SAPSⅡ and MODS scores were graded by recorded the heart rate（HR）,mean artiral pressure（MAP）,central venous pressure（CVP）,respiratory frequency and so on.【Results】 Compared with pre-treatment,APACHEⅡ,SAPSⅡ and MODS scores decreased after treatment.During the course of CBP,the blood creatinine,blood urea nitrogen and uric acid of patients all decreased.And the levels increased progressively with the longer of time.【Conclusions】 The improvement of cardio-pulmonary function relate to the dehydration or Interstitial edema of tissue and organs;the longer of time,the better of clearance of urea and creatine,but to the patient of creatinine within normal range urea and creatine normal,the time to therapy can be shortened,the profit of CBP to critical patients of the aged is a long process.

关 键 词：连续性血液净化 老年 重症急性胰腺炎 

分 类 号：R657.51[医药卫生—外科学]