早期连续性肾脏替代治疗在重症急性胰腺炎治疗中的应用评价  

Evaluation of Early Continuous Renal Replacement Therapy in the Treatment of Severe Acute Pancreatitis:A Prospective Randomized Controlled Study

作　　者：崔微艳[1] 徐海峰[1] 李勇[2] 颜骏[2] 蔡燕[2] 杨宏锋[2] 刘竞[2] 张清艳[2] 吉木森[2] 金兆辰[2] 

机构地区：[1]江苏大学附属武进医院重症医学科,213017 [2]江苏大学附属人民医院重症医学科

出　　处：《岭南急诊医学杂志》2017年第6期531-534,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:评价早期连续性肾脏替代治疗技术在重症急性胰腺炎治疗中的应用价值。方法:采用前瞻性随机对照研究方法,选择2012年5月至2014年5月间江苏大学附属人民医院ICU收治的重症急性胰腺炎患者27例,随机分为常规治疗组及CRRT治疗组,记录两组患者一般情况,病程中炎症及脏器功能指标变化情况,评价两组患者预后情况。结果:两组共纳入27例病例,其中常规治疗组11例,CRRT治疗组16例。CRRT治疗组TBi L、Cr、WBC计数、CRP水平较常规治疗组下降更为明显,需机械通气病例及平均机械通气天数低于常规治疗组。CRRT组前72 h所需液体量更少,差异有统计学意义(P<0.05)。CRRT组总住院时间较常规治疗组偏短,差异有统计学意义(P<0.05),ICU留置时间、90 d生存率等方面CRRT组亦体现出一定优势,但无明显统计学差异。结论:在SAP患者中早期执行CRRT治疗,可在一定程度上改善重要脏器功能,减少液体负荷,但其对SAP患者预后的影响尚需大样本临床试验进一步验证。Objective：The value of early continuous renal replacement therapy for the treatment of severe acute pancreatitis would be evaluated. Methods：The prospective randomized controlled study method is adapted. 27 patients with severe acute pancreatitis admitted in ICU in Peoples Hospital Affiliated to Jiangsu University from May 2012 to May 2014 are chosen and randomly divided into conventional treatment group and the CRRT treatment group to record changes in the course of inflammation and viscera function index of two groups of patients in general,and evaluate two groups of patients＇ prognosis. Results：Two groups of participants include 27 cases,of which there are 11 cases of the routine treatment group,and 16 cases of CRRT treatment group. The CRRT treatment groups TBi L,Cr,WBC count,CRP level are obviously decreased compared with conventional treatment group,and the number of mechanical ventilation cases and the average number of days for mechanical ventilation are less than those of the conventional treatment group. CRRT group needs less liquid within the first 72 hours,and the difference is statistically significant（P0.05）.The total hospitalization time of CRRT group is short,compared with the conventional group. This difference is statistically significant（P0.05）. As for ICU indwelling time and 90 d survival rate,CRRT group also has a certain advantage without significant statistical difference. Conclusion：CRRT is implemented for patients with SAP in the early and mid-dle treatment periods,which could improve the function of important organs to a certain extent,and reduce the liquidload,but its prognostic effect on patients with SAP still needs to be tested clinically with a large number of samples.

关 键 词：重症急性胰腺炎 连续性肾脏替代治疗 全身炎症反应综合征 

分 类 号：R576[医药卫生—消化系统]