血液灌流联合血液滤过治疗高脂血症性胰腺炎的疗效观察  

Observation of effect of hemoperfusion combined with hemofiltration in the treatment of hyperlipidemia pancreatitis

作　　者：钟贤君[1] 闭永浩[1] 龙涤[1] 黄恒艺[1] 谢林宏[1] 

机构地区：[1]广西钦州市第二人民医院,钦州535000

出　　处：《右江医学》2016年第1期63-66,共4页Chinese Youjiang Medical Journal

摘　　要：目的探讨血液灌流联合血液滤过治疗高脂血症性胰腺炎(HLP)的临床疗效。方法选取2014年2月至2015年2月收治的98例HLP患者,按随机数字表法分成两组,对照组49例予以常规治疗+血液滤过,观察组49例予以常规治疗+血液灌流+血液滤过。观察两组患者的心率(HR)、呼吸(R)、氧合指数(Pa O2/Fi O2)等心肺功能指标,检测三酰甘油(TG)、白细胞介素-6(IL-6)、C反应蛋白(CRP)等血液指标。采取急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)进行评价。结果治疗后,两组患者的心肺功能指标(HR、R、Pa O2/Fi O2)、APACHEⅡ评分与治疗前对比均明显改善(P<0.01);观察组治疗后的心肺功能指标(HR、R、Pa O2/Fi O2)、APACHEⅡ评分优于对照组(P<0.01)。治疗后,两组患者的TG、IL-6、CRP与同组治疗前对比均显著改善(P<0.01);观察组治疗后的TG、IL-6、CRP优于对照组(P<0.01)。观察组病死率为2.0%(1/49),对照组病死率为18.4%(9/49),两组病死率比较差异有统计学意义(P<0.01)。结论在常规治疗的基础上,血液灌流联合血液滤过治疗高脂血症性胰腺炎疗效确切,值得推广。Objective To explore the clinical effect of hemoperfusion combined with hemofiltration in the treatment of hyperlipidemia pancreatitis（ HLP）. Methods From February,2014 to February,2015,98 cases of patients with HLP were selected and randomly divided into observation group and control group with 90 cases in each group. The control group were treated with conventional treatment ＋ hemofiltration,while the observation group were given conventional treatment ＋ hemofiltration ＋ hemoperfusion. Then,cardio-pulmonary functional indexes like heart rate（ HR）,respiration（ R）,oxygenation index（ Pa O2/ Fi O2）,etc. were observed between groups. And blood indexes such as triacylglycerol（ TG）,interleukin-6（ IL-6）and C-reactive protein（ CRP）,etc. were tested. In addition,acute physiology and chronic health evaluation Ⅱ（ APACHEⅡ） was taken to evaluate all the above-mentioned indexes. Results After treatment,the cardio-pulmonary functional indexes（ HR,R,Pa O2/ Fi O2） and APACHE Ⅱ score of both groups significantly improved when comparing to those before treatment（ P〈0. 01）,and those of the observation group were superior to those of the control group（ P〈0. 01）. After treatment,TG,IL-6 and CRP of both groups significantly improved compared to those before treatment（ P〈0. 01）,and those of the observation group improved more significantly than those of the control group（ P〈0. 01）. Besides,mortality of the observation group was 2. 0%（ 1 /49）,significantly lower than that（ 18. 4%,9 /49） of the control group,and the difference was statistically significant（ P〈0. 01）. Conclusion On the basis of conventional treatment,hemoperfusion combined with hemofiltration has accurate curative effect for patients with hyperlipidemia pancreatitis. Thus,it is worthy of promotion in clinical practice.

关 键 词：高脂血症 急性胰腺炎 血液滤过 血液灌流 

分 类 号：R576[医药卫生—消化系统]