Ranson 评分在连续性血液净化治疗重症急性胰腺炎中的应用  

The application of Ranson scoring system on the treatment of severe acute pancreatitis with continuous blood purification

作　　者：王爱祥[1] 姜齐宏[1] 陈艳[1] 陈以莲[1] 

机构地区：[1]华中科技大学同济医学院附属普爱医院消化内科,湖北武汉430000

出　　处：《中国急救医学》2015年第4期351-354,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的：探讨Ranson评分指导连续性血液净化治疗（ CBP）治疗重症急性胰腺炎（ SAP）时机的选择。方法回顾性分析86例SAP患者的临床资料，按Ranson评分将患者分为3～4分、5～6分和＞6分三个分数段，比较各分数段是否行CBP治疗的两组患者28 d病死率、ICU住院时间、炎症因子（ TNF－α、IL－10）水平。结果 Ranson评分三分数段CBP治疗组ICU住院时间较对照组均明显降低。 Ranson评分3～4分与评分＞6分的治疗组与对照组病死率比较差异无统计学意义，评分5～6分的CBP治疗组患者的病死率明显降低。 Ranson评分三分数段炎症因子较治疗前均明显降低，Ranson评分3～4分及5～6分治疗组与对照组比较差异有统计学意义，Ranson评分＞6分治疗后炎症因子与对照组比较差异无统计学意义。结论 Ranson评分5～6分是采用CBP治疗SAP患者的最佳时机。Objective To explore the Ranson scoring system guides the treatment timing in severe acute pancreatitis （SAP） with continuous blood purification （CBP）.Methods A total of 86 SAP patients were divided into three scores sections randomly according to Ranson scoring system：3~4 points, 5~6, and〉6 points, and each section was divided into CBP group and control group.The length of stay ICU, the mortality of 28 d and the levels of inflammatory cytokines （ TNF-α, IL-10） were compared between the two groups in each section. Results The ICU length of stay was significantly reduced in CBP group in each section.The 28-day mortality was similar between the two groups in 3~4 points section and〉6 points section, but significantly lower in CBP group than in control group at the 5~6 points section.The levels of inflammatory cytokines in serum were decreased after CBP treatment in each section.The inflammatory cytokines were different between CBP group and control group in 3 ~4 points and 5 ~6 scores segment, but no significant difference in 〉6 points scores segment.Conclusion The best time of treatment SAP patients with CBP is 5 ~6 scores in Ranson scoring system.

关 键 词：RANSON评分 重症急性胰腺炎(SAP) 连续性血液净化治疗(CBP) 

分 类 号：R59[医药卫生—内科学]