持续大容量血液滤过联合生长抑素对急性重症胰腺炎患者预后的影响  

Effect of continuous large-volume hemofiltration combined with somatostatin on the prognosis of patients with acute severe pancreatitis

作　　者：王楠[1] 张晓燕[1] 孙宇 高维鸽[1] Wang Nan;Zhang Xiaoyan;Sun Yu;Gao Weige(Department of Intensive Care Medicine,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院重症医学科,乌鲁木齐830001

出　　处：《中国医师进修杂志》2023年第12期1095-1099,共5页Chinese Journal of Postgraduates of Medicine

基　　金：新疆维吾尔自治区自然科学基金资助项目(2020D01C112);新疆维吾尔自治区人民医院院内项目(20190426)。

摘　　要：目的探讨持续大容量血液滤过联合生长抑素对急性重症胰腺炎患者预后的影响。方法回顾性选择2019年10月至2021年10月在新疆维吾尔自治区人民医院治疗的106例急性重症胰腺炎患者,按照治疗方式不同分为药物组(53例)和滤过组(53例),药物组在常规治疗的基础上给予生长抑素滴注,滤过组在药物组治疗基础上给予持续大容量血液滤过治疗,比较两组治疗前后血清淀粉酶水平、临床疗效、各项临床指标及预后情况。结果滤过组治疗后3 d、治疗后1周血清淀粉酶水平低于药物组[(385.62±15.57)U/L比(426.83±18.21)U/L、(110.75±7.68)U/L比(162.74±9.12)U/L],差异有统计学意义(P<0.05)。滤过组治疗后总有效率高于药物组[90.57%(48/53)比75.47%(40/53)],差异有统计学意义(χ^(2)=4.28,P<0.05)。滤过组住院时间、胃肠减压时间、肠鸣音恢复时间短于药物组[(17.21±4.01)d比(20.56±4.57)d、(5.46±1.56)d比(7.98±1.79)d、(5.43±2.11)d比(6.78±2.54)d],差异有统计学意义(P<0.05)。滤过组治疗后3 d、治疗后1周胃肠道功能评分、急性生理学及慢性健康状况评估Ⅱ评分低于药物组[治疗后3 d:(1.64±0.35)分比(1.89±0.41)分、(23.42±2.71)分比(27.62±3.01)分;治疗后1周:(0.67±0.21)分比(1.01±0.32)分、(9.78±1.21)分比(15.62±1.58)分],差异有统计学意义(P<0.05)。滤过组28 d病死率低于药物组[5.66%(3/53)比20.75%(11/53)],差异有统计学意义(χ^(2)=5.27,P<0.05)。结论持续大容量血液滤过联合生长抑素治疗急性重症胰腺炎可有效降低患者血清淀粉酶水平,促进胃肠功能恢复,改善临床症状及预后。Objective To explore the effect of continuous large-volume hemofiltration combined with somatostatin on the prognosis of patients with acute severe pancreatitis.Methods A total of 106 patients with acute severe pancreatitis who were treated in the People's Hospital of Xinjiang Uygur Autonomous Region from October 2019 to October 2021 were enrolled retrospectively and they were divided into drug group(53 cases)and filtration group(53 cases)according to different treatment methods.The patients in the drug group were given somatostatin instillation on the basis of routine treatment,and the patients in the filtration group were given continuous large-volume hemofiltration therapy on the basis of the drug group.The serum amylase level,clinical efficacy,clinical indicators and prognosis were compared between the two groups.Results After treatment for 3 d and 1 week,the levels of serum amylase in the drug group were lower than those in the filtration group:(385.62±15.57)U/L vs.(426.83±18.21)U/L,(110.75±7.68)U/L vs.(162.74±9.12)U/L,there were statistical differences(P<0.05).The total effective rate in the filtration group was higher than that in the drug group:90.57%(48/53)vs.75.47%(40/53),χ^(2)=4.28,P<0.05.The hospitalization time,gastrointestinal decompression time and recovery time of bowel sounds in the filtration group were shorter than those in the drug group:(17.21±4.01)d vs.(20.56±4.57)d,(5.46±1.56)d vs.(7.98±1.79)d,(5.43±2.11)d vs.(6.78±2.54)d,there were statistical differences(P<0.05).After treatment for 3 d and 1 week,the scores of gastrointestinal function and acute physiology and chronic health assessment(APACHE)Ⅱ in the filtration group were lower than those in the drug group:after treatment for 3 d:(1.64±0.35)scores vs.(1.89±0.41)scores,(23.42±2.71)scores vs.(27.62±3.01)scores;after treatment for 1 week:(0.67±0.21)scores vs.(1.01±0.32)scores,(9.78±1.21)scores vs.(15.62±1.58)scores,there were statistical differences(P<0.05).After treatment for 28 d,the fatality rate in the filtration gr

关 键 词：生长抑素 血液滤过 胰腺炎 预后 

分 类 号：R576[医药卫生—消化系统]