连续性血液净化治疗重症急性胰腺炎合并MODS疗效观察  

Curative effects of continuous blood purification on severe acute pancreatitis complicated with multiple organ dysfunction syndrome

作　　者：张勇[1] 曾维政[1] 郑淑梅[1] 杨红霞[1] 周晓蕾[1] 蒋明德[1] 

机构地区：[1]成都军区总医院消化内科,成都610083

出　　处：《西南国防医药》2013年第6期612-614,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的观察连续性血液净化(CBP)治疗重症急性胰腺炎(SAP)合并多脏器功能障碍综合征(MODS)的疗效。方法选择我院2007年10月～2010年4月收治的SAP合并MODS患者26例,在内科综合治疗基础上,给予持续性血液净化(CBP)治疗3～7 d。监测CBP前后患者症状及血清生化指标变化,并进行APACHEⅡ、MODS评分比较。结果 CBP治疗后,患者发热、心动过速、呼吸窘迫、腹痛、腹胀等症状明显缓解,血清总胆红素、丙氨酸氨基转移酶、血清淀粉酶、尿素氮、肌酐、C-反应蛋白明显降低(P<0.05或P<0.01),酸中毒、低氧血症得到纠正,APACHEⅡ、MODS评分明显降低(P<0.01)。26例中,21例治愈或好转,5例死亡,存活率为80.1%。结论 CBP能改善、维持SAP患者内环境及重要脏器功能,对SAP并发MODS有较好的治疗作用,可迅速改善患者病情,降低病死率。Objective To observe the curative effects of continuous blood purification（CBP） on severe acute pancreatitis（SAP） complicated with multiple organ dysfunction syndrome（MODS）.Methods Twenty-six patients with SAP complicated with MODS hospitalized between October 2007 and April 2010 were selected to the study.Based on the combined therapies of internal medicine,these patients received CBP for 3-7 days.Their symptoms and changes of the serum biochemical indicators before and after CBP were monitored,and comparison was made in the APACHEⅡ and MODS scores.Results After CBP,the clinical symptoms such as fever,tachycardia,respiratory distress,abdominal pain,and distention were significantly relieved.The levels of serum total bilirubin,alanine aminotransferase,serum amylase,urea nitrogen,creatinine,and C-reactiver protein（CRP） all significantly decreased（P 0.05 or P 0.01）.Acidosis and hypoxemia were corrected.The APACHEⅡand MODS scores significantly decreased（P 0.01）.Among 26 cases,21 ones were cured or their symptoms were improved,and 5 ones died.The survival rate was 80.1%.Conclusion CBP can improve and maintain the patients＇ internal environment and the function of important organs.It has good therapeutic effects on patients with SAP complicated with MODS and can rapidly improve the pathogenetic conditions and reduce the mortality rate.

关 键 词：重症急性胰腺炎 多器官功能障碍综合征 连续性血液净化 疗效 

分 类 号：R657.5[医药卫生—外科学]