血浆置换联合血液滤过对高脂血症性重症急性胰腺炎的治疗价值评估分析  

Evaluation and Analysis of the Therapeutic Value of Plasma Exchange Combined with Hemofiltration in the Treatment of Severe Acute Pancreatitis with Hyperlipidemia

作　　者：苏琴 李娟 徐昆花 SU Qin;LI Juan;XU Kunhua(The Second People's Hospital of Qujing City,Qujing,Yunnan Province,655000 China)

机构地区：[1]曲靖市第二人民医院,云南曲靖655000

出　　处：《中外医疗》2022年第1期76-79,共4页China & Foreign Medical Treatment

摘　　要：目的分析血浆置换联合血液滤过对高脂血症性重症急性胰腺炎的治疗价值。方法随机选取2020年5月—2021年4月高脂血症性重症急性胰腺炎患者70例进行研究,根据不同治疗方式分为两组,每组35例,观察组行血浆置换联合血液滤过治疗,对照组行常规对症治疗,对比两组治疗效果。结果观察组的治疗总有效率97.14%,显著高于对照组的77.14%,差异有统计学意义(χ^(2)=4.590,P=0.032);观察组并发症总发生率2.86%,显著低于对照组的25.71%,差异有统计学意义(χ^(2)=7.467,P=0.006);治疗24 h后,观察组三酰甘油(5.10±1.23)、胆固醇(4.46±1.73)mmol/L均低于对照组(7.46±2.42)、(6.35±2.68)mmol/L,差异有统计学意义(t=5.143、3.505,P<0.05);观察组血淀粉酶(217.52±51.25)U/L、脂肪酶(325.42±83.12)U/L、APACHEⅡ(8.52±0.12)分均优于对照组(390.25±75.42)U/L、(654.20±163.52)U/L、(11.20±1.23)分,差异有统计学意义(t=11.027、10.604、12.829,P<0.05);观察组IL-6(8.52±1.42)pg/mL、TNF-α(15.42±2.45)pg/mL、CRP指标(13.25±4.12)mg/L均低于对照组(12.52±2.36)pg/mL、(22.45±3.42)pg/mL、(30.15±6.25)mg/L,差异有统计学意义(t=8.592、9.886、13.356,P<0.05)。结论高脂血症性重症急性胰腺炎患者应用血浆置换联合血液滤过治疗效果更佳,能够迅速起效,缓解患者高脂血症性重症急性胰腺炎的临床症状,帮助患者降低胆固醇水平和维持三酰甘油的稳定,疗效显著。Objective To analyze the therapeutic value of plasma exchange combined with hemofiltration in the treatment of severe acute pancreatitis with hyperlipidemia.Methods 70 patients with hyperlipidemia severe acute pancreatitis from May 2020 to April 2021 were selected randomly and divided into two groups according to different treatment methods,35 cases in each group.The observation group was treated with plasma exchange combined with hemofiltration,and the control group was treated with routine symptomatic treatment.The therapeutic effects of the two groups were compared.Results The total effective rate of the observation group was 97.14%,which was significantly higher than 77.14%of the control group,and the difference was statistically significant(χ^(2)=4.590,P=0.032).The total incidence of complications in the observation group was 2.86%,which was significantly lower than 25.71%in the control group,and the difference was statistically significant(χ^(2)=7.467,P=0.006).After 24 hours of treatment,the triglyceride(5.10±1.23)mmol/L and cholesterol(4.46±1.73)mmol/L in the observation group were lower than those in the control group(7.46±2.42)mmol/L and(6.35±2.68)mmol/L,the difference was statistically significant(t=5.143,3.505,P<0.05);The blood amylase(217.52±51.25)U/L,lipase(325.42±83.12)U/L,APACHE II(8.52±0.12)points in the observation groups were better than those in the control group(390.25±75.42)U/L,(654.20±163.52)U/L,(11.20±1.23)points,the difference was statistically significant(t=11.027,10.604,12.829,P<0.05).IL-6(8.52±1.42)pg/mL,TNF-α(15.42±2.45)pg/mL,CRP index(13.25±4.12)mg/L in the observation group were lower than those in the control group(12.52±2.36)pg/mL,(22.45±3.42)pg/mL,(30.15±6.25)mg/L,and the differences were statistically significant(t=8.592,9.886,13.356,P<0.05).Conclusion The treatment effect of plasma exchange combined with hemofiltration in patients with severe acute pancreatitis due to hyperlipidemia is better,and it can take effect quickly.Relieve the clinical symptoms of pati

关 键 词：血浆置换 血液滤过 高脂血症性重症急性胰腺炎 三酰甘油 胆固醇 

分 类 号：R657.51[医药卫生—外科学]