连续血液净化疗法在重症急性胰腺炎中的应用  

Application of continuous blood purification on patients with severe acute pancreatitis

作　　者：邢正云[1] 顾伟[1] 吴丽芳[1] 

机构地区：[1]江苏省大丰市人民医院ICU,大丰224100

出　　处：《安徽医学》2011年第3期314-316,共3页Anhui Medical Journal

摘　　要：目的探讨应用连续血液净化疗法在救治重症急性胰腺炎中的作用。方法选择重症急性胰腺炎患者9例,在常规治疗基础上,加用连续血液净化疗法,即连续静-静脉血液滤过（CVVH）治疗,采用前稀释法补充置换液,每次治疗12-72 h,平均46.3 h后更换滤器,根据病情持续治疗2-6 d不等,置换液流量2 000-4 000 ml/h,血流量150-300 ml/min,采用普通肝素抗凝。结果 9例患者中8例好转,1例放弃治疗,治疗后氧合指数、平均动脉压（MAP）、心率（HR）、急性生理及慢性健康状况评分Ⅱ（APACHEⅡ）评分均有所改善,治疗后血清肌酐、尿素氮、血淀粉酶、脂肪酶、血糖、C-反应蛋白下降明显。结论连续血液净化疗法在重症急性胰腺炎患者治疗过程中对血流动力学稳定,改善患者的内环境起重要作用,是治疗重症急性胰腺炎的有效措施之一。Objective To discuss the treatment effect of continuous blood purification（CBP） on patients with severe acute pancreatitis（SAP）.Methods The continuous blood purification was performed in 9 patients with severe acute pancreatitis.On the general treatment,the methods of CBP was applied,namely the filter was replaced between 12 to 72 hours（mean 46.3 hours）.According to the state of the patient＇s illness the CBP was performed continuously for 2 to 6 days.The ultra filtration rate during CBP was 2 000~4 000 ml/h and blood flow rate was 150~300 ml/min.Normal heparin was used as anticoagulant.Results Among 9 patients,8 were relived and one patient gave up.There were remarkable improvement in mean oxygenation index,arterial blood pressure,heart rate and APACHEⅡ（acute physiology and chronic health evaluation Ⅱ）.The muscle anhydride,urer nitrogen,serum sugar,serum amylase,lipase,C-reactive proteine were declined.Conclusion The therapy of CBP can stabilize the haemodynamic variables and improve the patients＇ inner circumstance.The CBP is an efficient method in the SAP.

关 键 词：连续血液净化 重症急性胰腺炎 治疗 

分 类 号：R576[医药卫生—消化系统]