持续血液净化治疗急性重症胰腺炎并急性呼吸窘迫综合征的临床疗效及机制  

Clinical observation of continuous blood purification of acute respiratory distress syndrome(ARDS) caused by severe acute pancreatitis

作　　者：洪勇[1] 廖文胜[1] 何阳阳[1] 李江发[1] 

机构地区：[1]桂林医学院附属南溪山医院腺体外科,广西桂林541002

出　　处：《中国现代医学杂志》2012年第25期97-99,共3页China Journal of Modern Medicine

摘　　要：目的对在临床治疗急性重症胰腺炎并急性呼吸窘迫综合征的治疗疗效进行观察和讨论。方法选取本院所接诊的急性重症胰腺炎并急性呼吸窘迫综合征患者56例,随机分为实验组和对照组,每组28例,对对照组采取常规治疗,对实验组除常规治疗加用采用持续血液净化(CBP)治疗。比较两组患者治疗后腹痛腹胀、胰腺水肿、血尿淀粉酶及白细胞恢复时间、住院天数、脱机时间、并发症发生率及病死率等指标,进行急性生理学及慢性健康状况评分(APACHEⅡ),监测血肿瘤坏死因子(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)、C反应蛋白(CRP)水平。结果两组腹痛腹胀、胰腺水肿、脱机时间、血尿淀粉酶及白细胞恢复时间、住院天数、并发症发生率及病死率等方面差异均有显著性(均P<0.05),低氧血症纠正,APACHEⅡ评分改善,TNF-α、IL-6、IL-8、CRP水平下降(均P<0.05),治疗组疗效显著优于对照组。结论在临床治疗急性重症胰腺炎并急性呼吸窘迫综合征时,尽早采取持续血液净化治疗效果好,其机制可能与清除体内炎症介质有关。【Objective】 To investigate the effect of continuous blood purification on acute respiratory distress syndrome（ARDS） caused by severe acute pancreatitis.【Methods】 56 patients with acute respiratory distress syndrome（ARDS） caused by severe acute pancreatitis were randomly divided into continuous blood purification treatment（CBP） group（experimental group,28 cases） and the conventional therapy group（control group,28 cases）.Both groups were given basic treatment,experimental group were given CBP treatment on the basis of the control group.Their general conditions,hospital stay,complication rate and mortality rate,APACHEⅡ score were observed.TNF-a,IL-6,IL-8,CRP were measured as well.【Results】 Two groups were compared with significant differences in patients with abdominal distension,pancreatic edema,urine amylase and white blood cell recovery time,hospital stay,complication rate and mortality rate etc（P 0.05）.And acidosis and hypoxemia were corrected（P 0.05）;the APACHEⅡ score decreased（P 0.05）,and TNF-a,IL-6,IL-8,CRP decreased significantly（P 0.05）.Effects in experimental group were significantly better than the control group.【Conclusions】 CBP is more effective in the treatment of cute respiratory distress syndrome（ARDS） caused by severe acute pancreatitis,and the mechanism may be related to the remove of mediators of inflammation.

关 键 词：持续血液净化 急性呼吸窘迫综合征 急性重症胰腺炎 

分 类 号：R657.5[医药卫生—外科学]