急性重症胰腺炎患者早期行连续性肾替代治疗的临床价值  

Clinical value of early continuous renal replacement therapy for patients with acute severe pancreatitis

作　　者：郑健[1] 刘虹[1] 曹静[1] Zheng Jian;Liu Hong;Cao Jing(Department of Critical Care Medicine,the First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院重症医学科,太原030001

出　　处：《中国实用医刊》2019年第23期89-91,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨早期实施连续性肾替代治疗(CRRT)对急性重症胰腺炎(SAP)患者的临床价值。方法选取2016年3月至2019年3月山西医科大学第一医院收治的SAP患者82例为研究对象,根据患者入院治疗顺序将其分为对照组与观察组,每组41例。对照组接受常规综合治疗,观察组接受早期CRRT治疗。比较分析两组患者的治疗效果。结果两组治疗前Apache II、视觉模拟评分法(VAS)评分比较差异未见统计学意义(P>0.05)。治疗后3 d,观察组及对照组Apache II、VAS评分均下降,且观察组下降幅度及ICU住院时间均优于对照组(P<0.05)。治疗前两组肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、血淀粉酶(AMS)水平比较差异未见统计学意义(P>0.05);治疗后3 d,观察组及对照组TNF-α、IL-1β、AMS水平较治疗前下降,且观察组下降幅度优于对照组(P均<0.05)。观察组急性肺损伤/急性呼吸窘迫综合征(19.51%)、机械通气(21.95%)、死亡(4.88%)发生率均低于对照组(51.22%、58.54%、24.39%),差异有统计学意义(P<0.05)。结论对SAP患者实施早期CRRT治疗效果显著,有利于保障其预后。Objective To investigate the therapeutic value of early continuous renal replacement therapy(CRRT)for patients with acute severe pancreatitis(SAP).Methods Eighty-two patients with SAP treated in the First Hospital of Shanxi Medical University from March 2016 to March 2019 were enrolled.The patients were divided into the control group and the observation group according to the order of admission,with 41 cases in each group.Patients in the control group received routine comprehensive treatment,and patients in the observation group received early CRRT treatment.The treatment outcomes of the two groups were analyzed.Results There was no significant difference in the scores of Apache II or visual analogue scale(VAS)between the two groups(P>0.05).The scores of Apache II and VAS were decreased in bothe groups 3 days after treatment,and the decreases and intensive care unit time in the observation group were superior to those in the control group(P all<0.05).The levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and amylase(AMS)in observation group did not significantly differ from those in the control group before therapy(P>0.05).However,the levels of TNF-α,IL-1βand AMS in the observation group were better than those in the control group,and the decrease in observation were greater 3 days after treatment(P all<0.05).The incidences of acute lung injury/acute respiratory distress syndrome(19.51%),mechanical ventilation(21.95%),and death(4.88%)was significantly lower than those of the control group,which were 51.22%,58.54%,24.39%,respectively,and the difference were significant(P<0.05).Conclusions The early CRRT treatment for SAP patients is effective,and it is beneficial to the prognosis.

关 键 词：肾替代治疗 急性重症胰腺炎 临床价值 

分 类 号：R576[医药卫生—消化系统]