综合对症联合连续性静脉-静脉血液滤过+血液灌流治疗急性胰腺炎的效果观察  

Observation on the effect of comprehensive symptomatic combination with continuous venovenous hemofiltration and hemoperfusion in the treatment of acute pancreatitis

作　　者：王义大 Wang Yida(Second Department of General Surgery,Linyi Cancer Hospital,Linyi 276000,China)

机构地区：[1]山东省临沂市肿瘤医院普外二科,276000

出　　处：《现代养生》2023年第9期650-654,共5页Health Protection and Promotion

摘　　要：目的 探讨综合对症联合连续性静脉-静脉血液滤过(CVVH)+血液灌流(HP)治疗对急性胰腺炎(AP)患者心肾功能及血清淀粉酶(AMY)、降钙素原(PCT)水平的影响。方法 选取2020年4月-2022年4月医院治疗的88例AP患者作为研究对象,根据组间性别、年龄、发病原因等基线资料均衡可比的原则分为观察组44例和对照组44例。观察组给予综合对症联合CVVH+HP治疗,对照组仅给予综合对症治疗,比较两组治疗前后心功能指标[左心室射血分数(LVEF)、心排出量(CO)与每搏输出量(SV)]、肾功能指标[肌酐(Scr)、尿素氮(BUN)、尿酸(UA)]、血清AMY和PCT水平,以及急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分和生存率。结果 治疗前,两组心功能、肾功能、AMY、PCT水平和APACHEⅡ评分比较,差异均无统计学意义(P>0.05);治疗后,观察组LVEF、CO及SV心功能指标均高于对照组,Scr、BUN及UA肾功能指标低于对照组,差异有统计学意义(P<0.05)。观察组治疗后血清AMY、PCT水平均比对照组低,差异有统计学意义(P<0.05)。观察组治疗后APACHEⅡ评分比对照组低,差异有统计学意义(P<0.05)。观察组入院治疗7d内生存率为97.73%,高于对照组的84.09%,但差异无统计学意义(P>0.05)。结论 综合对症联合CVVH+HP治疗AP患者临床效果显著,能有效改善心肾功能,减轻炎症反应,控制病情发展,提升患者预后。Objective To explore the effect of comprehensive symptomatic treatment combined with continuous veno-venous hemofiltration(CVVH)and hemoperfusion(HP)on cardiac and renal function and serum amylase(AMY)and procalcitonin(PCT)levels in patients with acute pancreatitis(AP).Methods Eighty-eight patients with AP who were treated in the hospital from April 2020 to April 2022 were selected as the study subjects.According to the principle of balanced and comparable baseline data such as sex,age,and cause of disease among the groups,44 patients were divided into the observation group and 44 patients in the control group.The observation group was given comprehensive symptomatic treatment combined with CVVH+HP,while the control group was only given comprehensive symptomatic treatment.The cardiac function indexes[left ventricular ejection fraction(LVEF),cardiac output(CO)and stroke volume(SV)],renal function indexes[serum creatinine(Scr),blood urea nitrogen(BUN),uric acid(UA)],serum levels of AMY,PCT,and the acute physiology and acute physiology and chronic health evaluation II(APACHE I)score and survival rate were compared before and after treatment.Results Before treatment,there was no significant difference between the two groups in cardiac function,renal function,AMY,PCT level and APACHE II score(P>0.05).After treatment,the indexes of LVEF,CO and SV cardiac function in the observation group were higher than those in the control group,while the indexes of Scr,BUN and UA renal function in the observation group were lower than those in the control group,with a statistically significant difference(P<0.05).After treatment,the levels of serum AMY and PCT in the observation group were lower than those in the control group,and the diference was statistically significant(P<0.05).After treatment,the APACHE II score in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The survival rate of the observation group was 97.73%within 7 days after admission,higher than 84

关 键 词：综合对症治疗 连续性静脉-静脉血液滤过 血液灌流 急性胰腺炎 心肾功能 

分 类 号：R576[医药卫生—消化系统]