CVVH与血浆置换治疗妊娠期高脂血症性胰腺炎的疗效观察  

The prognosis of patients with hyperlipidemic acute pancreatitis in pregnancy treated by continuous veno-venous hemofiltration and plasma exchange

作　　者：赵晶伟 杜怡 周晓峰 季青 杨盼 李月霞 马亚丹 王亚迪 孙俊丽 潘英慧 刘一飞 

机构地区：[1]郑州大学附属洛阳中心医院血液净化中心,洛阳471009 [2]郑州大学附属洛阳中心医院GICU,洛阳471009

出　　处：《中国血液净化》2017年第10期688-691,共4页Chinese Journal of Blood Purification

摘　　要：目的探讨并比较连续性血液滤过(continuous veno-venous hemofiltration,CVVH)与CVVH联合血浆置换(plasma exchange,PE)2种治疗方式在治疗妊娠期高脂血症性胰腺炎(hyperlipidemic acute pancreatitis in pregnancy,HLAPIA)中的临床疗效。方法郑州大学附属洛阳市中心医院2011年5月到2017年5月被收治入院的妊娠期高脂血症性胰腺炎30例病例,随机分为2组,均给予常规内科治疗。CVVH组另予持续血液滤过,疗程5d;CVVH+PE组另予持续血液滤过,疗程5d,同时予以血浆置换3次。比较2组患者治疗有效率、症状缓解时间、禁食时间、住院时间及相关实验室血液指标之间的差异。结果 CVVH+PE组的治疗有效率为93.33%,高于CVVH组53.33%,且2组间有统计学差异(P=0.035)。CVVH+PE组症状缓解时间(t=3.850,P<0.001)、禁食时间(t=5.290,P<0.001)与住院时间(t=4.890,P<0.001)均显著低于CVVH组,差异有统计学意义。治疗后,CVVH+PE组的白细胞(t=4.870,P<0.001)、C反应蛋白(t=10.390,P<0.001)、三酰甘油(t=5.230,P<0.001)、总胆固醇(t=5.370,P<0.001)明显低于CVVH组,而2组之间的淀粉酶(amylase AMY)、脂肪酶(lipase LPS)则无明显差异。Objective To study the prognosis of hyperlipidemic acute pancreatitis in pregnancy（HLAPIP） patients treated by continuous veno-venous hemofiltration（CVVH） or CVVH plus plasma exchange（PE）. Methods We recruited 30 patients diagnosed with HLAPIP in Luoyang Central Hospital, Zhengzhou University and randomly divided them into 2 groups. The CVVH group received CVVH for 5 days, and the CVVH＋PE group received plasma exchange 3 times in addition to CVVH5 for 5 days. We then compared treatment efficiency, symptom alleviating time, fasting time, hospitalization days and laboratory blood indices between the two groups. Results The treatment efficiency is 93.33% in CVVH ＋ PE group, higher than53.33%（P=0.035） in CVVH group. The symptom alleviating time（t =3.850, P〈0.001）, fasting time（t =5.290, P〈0.001）, hospitalization days（t =4.890, P〈0.001） are shorter in CVVH ＋ PE group than in CVVH group. After the treatment, white blood cell（t =4.870, P〈0.001）, C response protein（t=10.390, P〈0.001）, triglyceride（t =5.230, P〈0.001） and total cholesterol（t =5.370, P〈0.001） are lower in CVVH＋PE group than in CVVH group; while amylase and lipase have no significant differences between the two groups.

关 键 词：CVVH 血浆置换 妊娠 高脂血症性胰腺炎 

分 类 号：R459.5[医药卫生—治疗学]