早期高流量血液滤过联合微创置管引流术在重症急性胰腺炎腹腔间室综合征治疗中的应用价值  

Application value of treatment of abdominal compartment syndrome in severe acute pancreatitis patients by combined early high flow hemofiltration and minimally invasive catheter drainage

作　　者：杨志勇[1] 

机构地区：[1]广东省茂名市人民医院神经重症医学科,广东茂名525000

出　　处：《中国医药导报》2015年第22期78-81,88,共5页China Medical Herald

基　　金：广东省茂名市医学科技计划立项项目(20102011)

摘　　要：目的探讨早期高流量血液滤过联合微创置管引流术在重症急性胰腺炎腹腔间室综合征治疗中的应用价值。方法 选择2010年1月-2014年10月在广东省茂名市人民医院接受治疗的重症急性胰腺炎腹腔间室综合征患者98例,按照随机数字表法分为联合组与对照组。对照组在传统对症支持治疗的基础上行早期高流量血液滤过治疗,联合组在对照组治疗的基础上行微创置管引流治疗。观察两组患者治疗前后白介素-6（IL-6）、白介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、血钾（K^＋）、血铬（Cr）、血尿素氮（BUN）、胃肠黏膜p H、平均动脉压（MAP）、呼吸频率（R）、心率（HR）等指标及预后情况。结果 联合组治疗后IL-6[（173.82±6.82）pg/m L]、IL-10[（27.59±2.31）pg/m L]、TNF-α[（29.13±2.76）pg/m L]、CRP[（202.65±10.83）mg/L]均显著低于对照组治疗后IL-6[（207.82±6.27）pg/m L]、IL-10[（50.38±4.02）pg/m L]、TNF-α[（61.98±4.87）pg/m L]、CRP[（235.76±11.72）mg/L],差异均有统计学意义（均P〈0.05）。联合组治疗后血K^＋[（4.11±0.65）mmol/L]、血Cr[（385.87±11.85）mmol/L]、BUN[（14.02±2.75）mmol/L]均显著低于对照组治疗后血K＋[（4.78±0.76）mmol/L]、血Cr[（406.20±11.54）mmol/L]、BUN[（17.03±2.84）mmol/L],差异均有统计学意义（均P〈0.05）。联合组治疗后胃肠黏膜p H（7.30±0.35）与对照组治疗后胃肠黏膜p H（7.26±0.31）比较,差异无统计学意义（P〉0.05）。联合组治疗后R[（22.76±1.96）次/min]、HR[（88.76±5.92）次/min]均显著低于对照组治疗后R[（25.15±1.87）次/min]、HR[（93.63±5.87）次/min],MAP[（117.98±6.82）mm Hg]显著高于对照组治疗后MAP[（108.78±6.77）mm Hg],差异均有统计学意义（均P〈0.05）。联合组存活率（73.47%）显著高于对照组存活率（51.02%）,差异有统计学意义（P〈0.05）。结论 早期高流量血液滤�Objective To discuss the application value of treatment of abdominal compartment syndrome in severe acute pancreatitis patients by combined early high flow hemofiltration and minimally invasive catheter drainage. Methods 98 cases of patients with severe acute pancreatitis complicated by abdominal compartment syndrome in Maoming People＇s Hospital from January 2010 to October 2014 were chosen. According to random number tables method, the patients were divided into the combined group and control group. The control group was given early high flow hemofiltration treatment based on traditional treatment, while the combined group was given minimally invasive catheter drainage based on the control group. The interleukin-6（IL-6）, interleukin-10（IL-10）, tumor necrosis factor-α（TNF alpha）, C reactive protein（CRP）, blood K^＋, blood Cr, blood urea nitrogen（BUN）, p H of gastric mucous membrane, mean arterial pressure（MAP）, breathing rate（R）, heart rate（HR） of the two groups before and after treatment were recorded.Results After treatment IL-6 [（173.82±6.82） pg/m L], IL-10 [（27.59±2.31） pg/m L], TNF-α [（29.13±2.76） pg/m L], CRP[（202.65-10.83） mg/L] of combined group were significantly lower than the control group IL-6 [（207.82±6.27） pg/m L],IL-10 [（50.38±4.02） pg/m L], TNF-α [（61.98±4.87） pg/m L], CRP [（235.76±11.72） mg/L], with statistically significant differences（P〈0.05）. After treatment blood K-＋[（4.11±0.65） mmol/L], blood Cr [（385.87±11.85） mmol/L], blood BUN [（14.02±2.75） mmol/L] of the combined group were significantly lower than the control group blood K^＋[（4.78±0.76） mmol/L],blood Cr [（406.20±11.54） mmol/L], blood BUN [（17.03±2.84） mmol/L], with statistically significant differences（P〈0.05）. After treatment gastrointestinal mucous membrane p H（7.30±0.35） of the combined group slightly higher than the control group p H of gastrointestinal mucosa（7.26±0.31）, with no statistically signific

关 键 词：早期高流量血液滤过 微创置管引流术 重症急性胰腺炎 腹腔间室综合征 

分 类 号：R656[医药卫生—外科学]