高吸附血液灌流治疗对高三酰甘油血症性急性胰腺炎疗效影响的单中心研究  

A single-center study on the effect of high adsorption hemoperfusion therapy on the efficacy of hypertriglyceridemic acute pancreatitis

作　　者：王兴 鲁厚清[1] 汪俊 Wang Xing;Lu Houqing;Wang Jun(Department of Critical Care Medicine,Tongling People's Hospital,Tongling 241000,Anhui,China)

机构地区：[1]铜陵市人民医院重症医学科,安徽铜陵241000

出　　处：《中国中西医结合急救杂志》2024年第5期572-576,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：皖南医学院中青年科研基金项目(JXYY202217)。

摘　　要：目的探讨高吸附血液灌流对高三酰甘油血症性急性胰腺炎(HLAP)的治疗作用。方法采用回顾性研究方法,选择2020年5月1日至2023年7月31日铜陵市人民医院重症医学科收治的经高吸附血液灌流治疗的HLAP患者作为研究对象。将患者按使用灌流器不同分为HA380高吸附血液灌流器组和HA330普通吸附血液灌流器组。观察HA380高吸附血液灌流器治疗前后生命体征的变化,并比较HA380高吸附血液灌流器组和HA330普通吸附血液灌流器组灌流前后三酰甘油(TC)和血淀粉酶水平的差异。结果共纳入26例患者,其中HA380高吸附血液灌流器组16例,HA330普通灌流器组10例。随灌流次数的增多,HA380高吸附血液灌流器组患者心率、体温、呼吸频率均逐渐降低[心率(次/min):105.38±21.44、95.31±17.56比119.93±21.06,体温(℃):37.31±0.88、37.22±0.69比37.99±1.17,呼吸频率(次/min):19.44±5.12、17.00±4.83比21.94±5.12,均P<0.05],收缩压均逐渐升高[mmHg(1mmHg~0.133kPa):106.81±11.04、120.13±9.14比97.44土8.23,均P<0.05];HA380高吸附血液灌流器组和HA330普通吸附血液灌流器组灌流后TG和血淀粉酶水平均逐渐降低,第2次灌流后达到最低水平,且HA380高吸附血液灌流器组TG和血淀粉酶水平均明显低于HA330普通吸附血液灌流器组[TG(mmol/L):9.63±2.57比15.52±4.07,血淀粉酶(U/L):759.63±153.29比973.90±125.94,均P<0.05]。结论HLAP采用血液滤过+高吸附血液灌流可迅速缓解症状,降低血脂水平,减轻胰腺炎的严重程度。Objective To explore the therapeutic effect of high adsorption hemoperfusion1on hypertriglyceridemic acute pancreatitis(HLAP).Methods A retrospective study was conducted.HLAP patients who received high adsorption hemoperfusion treatment in the Department of Critical Care Medicine,Tongling People's Hospital from May 1.,2020 to July 31,2023 were selected as the research objects.The patients were divided into the HA380 high adsorption hemoperfusion group and the HA330 ordinary adsorption hemoperfusion group according to different hemoperfusion devices used.The changes in vital signs before and after treatment with the HA380 high adsorption hemoperfusion device were observed,and the differences in triglyceride(TG)and blood amylase levels before and after hemoperfusion were compared between the HA380 high adsorption hemoperfusion group and the HA330 ordinary adsorption hemoperfusion group.Results A total of 26 patients were included,with 16 cases in the HA380 high adsorption hemoperfusion group and 10 cases in the HA330 ordinary hemoperfusion group.With the increase in the number of hemoperfusion sessions,the heart rate,body temperature,and respiratory rate of the patients in the HA380 high adsorption hemoperfusion group gradually decreased[heart rate(bpm):105.38±21.44,95.31±17.56 vs.119.93±21.06,body temperature(℃):37.31±0.88,37.22±0.69vs.37.99±1.17,respiratory rate(times/min):19.44±5.12,17.00±4.83 vs.21.94±5.12,all P<0.05],and the systolic blood pressure gradually increased[mmHg(1 mmHg~0.133 kPa):106.81±11.04.120.13±9.14 vs.97.44±8.23,both P<0.05].The TG and blood amylase levels in both the HA380 high adsorption hemoperfusion group and the HA330 ordinary adsorption hemoperfusion group gradually decreased after hemoperfusion,reaching the lowest level after the second hemoperfusion,and the TG and blood amylase levels in the HA380 high adsorption hemoperfusion group were significantly lower than those in the HA330 ordinary adsorption hemoperfusion group[TG(mmol/L):9.63±2.57 vs.15.52±4.07,blood amylase(U

关 键 词：高三酰甘油血症性急性胰腺炎 血液净化 血液灌流 

分 类 号：R54[医药卫生—心血管疾病]