血液灌流联合血液透析治疗重症急性胰腺炎合并急性肾损伤的临床疗效观察  

Clinical effect of blood perfusion combined with hemodialysis in the treatment of severe acute pancreatitis complicated with acute kidney injury

作　　者：李和莅[1] 

机构地区：[1]成都市第二人民医院急诊科,四川成都610017

出　　处：《实用医院临床杂志》2016年第5期134-136,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨血液灌流(HP)联合血液透析(HD)治疗重症急性胰腺炎(SAP)合并急性肾损伤(AKI)的临床疗效。方法 2010年1月至2015年3月我院急诊科收治的92例SAP合并AKI患者,按照随机数字表法分为观察组和对照组各46例。在内科综合治疗的基础上,对照组采用常规HD治疗,观察组采用HD联合HP治疗。比较两组各项临床疗效指标和血液指标。结果观察组腹痛消失时间、腹膜刺激征消失时间、血液净化时间及住院天数均明显短于对照组,C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)、肌酐(Scr)、尿素氮(BUN)、谷草转氨酶(AST)水平及病死率均低于对照组,差异均有统计学意义(P<0.05)。结论 HP联合HD治疗SAP合并AKI,可有效清除体内炎症递质,降低患者病死率,是安全有效的治疗方法。Objective To investigate the clinical effect of blood perfusion （HP） combined with hemodialysis （HD） in the treatment of severe acute pancreatitis （SAP） complicated with acute kidney injury （AKI）. Methods Ninetytwo patients with SAP and AKI were treated in emergency department of our hospital from January 2010 to March 2015. These cases were divided into observation or control group according to random number table, 46 eases in each group. Based on medical treatment, the control group received conventional HD treatment, and the observation group received the treatment of HD and HP. The clinical efficacy and hemato- logic indices were compared between the two groups. Results The time of abdominal pain disappearing and peritoneal irritation symptoms, blood purification time and length of hospital stay in the observation group were significantly shorter than those in the control group. Serum levels of CRP, TNF, IL-2, SCR, bun and AST as well as mortality rate were lower in the observation group than those in the control group. All differences were statistically significant （ P 〈 0.05 ）. Conclusion HP combined with HD in the treatment of SAP complicated with AKI can effectively eliminate the inflammation of the body and reduce the patient＇s mortality. It is a safe and effective treatment method.

关 键 词：重症急性胰腺炎 急性肾损伤 血液灌流 血液透析 

分 类 号：R459.5[医药卫生—治疗学]