自动腹膜透析与连续性肾替代疗法治疗重症急性胰腺炎的效果对比  

Comparison of the effect of automated peritoneal dialysis and continuous renal replacement therapy in the treatment of severe acute pancreatitis

作　　者：吴静[1] 马国英 陈爽[1] 崔梦笔 杨宇齐 查艳[1] WU Jing;MA Guo-ying;CHEN Shuang;CUI Meng-bi;YANG Yu-qi;ZHA Yan(Department of Nephrology,Guizhou Provincial People′s Hospital,Guiyang 550002,China;Department of Nephrology,Qiandongnan State People′s Hospital,Guizhou Province,Kaili 556000,China)

机构地区：[1]贵州省人民医院肾内科,贵州贵阳550002 [2]贵州省黔东南州人民医院肾内科,贵州凯里556000

出　　处：《中国当代医药》2018年第30期4-7,共4页China Modern Medicine

基　　金：国家自然科学基金地区基金项目(81760134);贵州省贵阳市科技计划项目(筑科合同[20161001]38号)

摘　　要：目的比较自动腹膜透析(APD)与连续性肾替代疗法(CRRT)治疗重症急性胰腺炎(SAP)的效果。方法回顾性分析2012年10月～2017年12月在贵州省人民医院确诊为SAP并接受血液净化治疗的76例患者的临床资料,按照治疗方式的不同分为APD组(39例)与CRRT组(37例)。比较两组患者的腹痛、腹胀缓解时间,血淀粉酶和尿淀粉酶降至正常的时间,观察两组治疗第3、7天的Balthazar CT积分、APACHEⅡ评分情况以及白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子(TNF-α)下降情况。结果 APD组的腹痛、腹胀缓解时间,血尿淀粉酶降至正常的时间显著短于CRRT组,差异有统计学意义(P<0.05)。APD组的BalthazarCT积分、APACHEⅡ评分以及IL-6、CRP、PCT、TNF-α显著低于与CRRT组,差异有统计学意义(P<0.05)。结论 APD治疗SAP临床效果显著,值得临床推广。Objective To compare the effect of automated peritoneal dialysis(APD)and continuous renal replacement therapy(CRRT)in the treatment of severe acute pancreatitis(SAP).Methods The clinical data of 76 patients with SAP diagnosed in Guizhou Provincial People′s Hospital and received blood purification therapy from October 2012 to December 2017 were retrospectively analyzed.According to the different treatment,they were divided into the APD group(39 cases)and the CRRT group(37 cases).The relief times of abdominal pain and distension,recovery times of serum and urine amylase levels were compared between the two groups,the changes of Balthazar CT score,APACHEⅡscore,the levels of interleukin-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT)and tumour necrosis factorα(TNF-α)were compared at the 3 and 7 days after treatment.Results The relief times of abdominal pain and distension and recovery times of amylase levels in the APD group were significant shorter than those in the CRRT group,with significant difference(P<0.05).The Balthazar CT score,APACHEⅡscore,the level of IL-6,CRP,PCT and TNF-αin the APD group were lower than those in the CRRT group,with significant difference(P<0.05).Conclusion APD in the clinical treatment of SAP is significant effective,and which is worthy for popularizing application.

关 键 词：自动腹膜透析 连续性肾替代疗法 重症急性胰腺炎 

分 类 号：R692[医药卫生—泌尿科学]