持续血液滤过与血浆置换对高脂血症性急性胰腺炎的疗效对比  

Comparative study of continuous hemofiltration and plasma exchange therapy for acute hyperlipidemic pancreatitis

作　　者：王华杰[1] 苏醒[1] 谢晓红[1] 

机构地区：[1]海南省人民医院重症医学科,海南海口570311

出　　处：《胃肠病学和肝病学杂志》2015年第8期997-999,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的观察持续血液滤过和血浆置换两种方法治疗高脂血症性急性胰腺炎(acute hyperlipidemic pancreatitis,AHLP)的临床效果。方法选择海南省人民医院2011年4月-2014年2月确诊收治的AHLP患者98例,分为血液滤过组(58例)和血浆置换组(40例),两组患者均给予常规内科治疗,血液滤过组在常规治疗的基础上给予持续血液滤过治疗,血浆置换组在常规治疗基础上给予血浆置换治疗;治疗后,对比两组患者的禁食时间、症状缓解时间、住院时间、治疗的有效率及TG、IL-6、TNF-α等实验室指标。结果治疗后血液滤过组总有效率为79.3%,血浆置换组为82.5%,两组相比,差异无统计学意义(P>0.05);但血浆置换组患者的禁食时间、症状缓解时间、住院时间均明显低于血液滤过组,且治疗后3 d和5 d时血液置换组患者的TG、IL-6、TNF-α水平均明显低于血液滤过组,差异有统计学意义(P<0.05)。结论持续的血液滤过与血浆置换都是治疗AHLP的理想方法,两种方法均有显著的治疗效果,但血浆置换能够更迅速地降低患者体内TG和炎症程度,是更加理想的方法。Objective To compare the clinical effect of plasma exchange and hemofiltration in the treatment of acute hyperlipidemic pancreatitis （AHLP）. Methods Ninety-eight AHLP patients were divided into hemofiltration group with 58 cases and plasma exchange group with 40 cases, and hemofiltration group was given continuous hemofiltration treatment on the basis of conventional therapy, while the plasma exchange group was treated with plasma exchange thera- py based on the basis of conventional therapy; after treatment, the fasting time, symptoms time, hospitalization time, the treatment efficiency and TG, IL-6, TNF-α and other laboratory indexes were observed between two groups. Results The total effective rate of hemofiltration group was 79.3% , while it was 82.5% in the plasma exchange group, there was no significant difference between two groups （P 〉 0.05） ; but the fasting time, symptoms time, hospitalization time in plasma exchange group were significantly lower than those in the hemofiltration group, at the 3 days and 5 days of treatment, TG, IL-6, TNF-α levels in plasma exchange group were significantly lower than those in the hemofiltration group, the differences were statistically significant （P 〈 0.05）. Conclusion Continuous hemofiltration and plasma ex- change are ideal methods in the treatment of AHLP, they have high therapeutic effect, but plasma exchange can quickly reduce the levels of TG and the degree of inflammation, is a more ideal method.

关 键 词：血液滤过 血浆置换 急性胰腺炎 高血脂 

分 类 号：R576[医药卫生—消化系统]