早期连续性血液净化对重症急性胰腺炎患者血清学指标及胰腺微循环的影响  

Effects of Early Continuous Blood Purification on Serological Indexes and Pancreatic Microcirculation in Patients with Severe Acute Pancreatitis

作　　者：游慧玲 卢志萍 YOU Huiling;LU Zhiping(Department of Critical Care,Longyan People's Hospital,Longyan 364000,China;不详)

机构地区：[1]龙岩人民医院重症医学科,福建龙岩364000 [2]龙岩市第二医院重症医学科,福建龙岩364000

出　　处：《中国医学创新》2025年第5期123-126,共4页Medical Innovation of China

摘　　要：目的:探究早期连续性血液净化对重症急性胰腺炎患者血清学指标及胰腺微循环的影响。方法:将2021年10月-2023年12月龙岩人民医院收治的80例重症急性胰腺炎患者根据随机数字表法分为两组,每组40例。对照组进行常规治疗,观察组则在对照组基础上进行早期连续性血液净化治疗。比较两组治疗总有效率、症状体征(发热、腹痛及腹胀)消失时间、血清学指标[胰腺炎敏感指标淀粉酶(AMS)、脂肪酶(LPS)及炎症指标肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、可溶性B7同源体4(sB7-H4)]及胰腺微循环[血容量(BV)、血流量(BF)及表面通透性(PS)]。结果:观察组治疗总有效率显著高于对照组,症状体征消失时间均显著早于对照组,差异均有统计学意义(P<0.05)。治疗前两组血清学指标及胰腺微循环指标比较,差异均无统计学意义(P>0.05);治疗3、5 d后,观察组血清学指标均显著低于对照组,治疗5 d后,观察组BV及BF均显著高于对照组,PS显著低于对照组,差异均有统计学意义(P<0.05)。结论:早期连续性血液净化在重症急性胰腺炎患者中的应用效果较好,且可显著改善血清学指标、胰腺微循环,减轻炎症反应,促进患者早期恢复。Objective:To investigate the effects of early continuous blood purification on serological indexes and pancreatic microcirculation in patients with severe acute pancreatitis.Method:A total of 80 patients with severe acute pancreatitis admitted to Longyan People's Hospital from October 2021 to December 2023 were divided into two groups according to random number table method,with 40 cases in each group.The control group received routine treatment,and the observation group received early continuous blood purification treatment on the basis of control group.The total effective rate,the disappearance time of symptoms and signs(faver,abdominal pain and abdominal bloating),serological indexes[amylase(AMS),lipase(LPS)of pancreatitis sensitive indexes,tumor necrosis factor-α(TNF-α),C reactive protein(CRP),soluble B7 homolog 4(sB7-H4)of inflammatory indexes]and pancreatic microcirculation[blood volume(BV),blood flow(BF)and permeability surface(PS)]between the two groups were compared.Result:The total effective rate of the observation group was significantly higher than that of the control group,and the disappearance time of symptoms and signs were significantly earlier than those of the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in serological indexes and pancreatic microcirculation indexes between the two groups(P>0.05).After 3 and 5 days of treatment,serological indexes in the observation group were significantly lower than those in the control group,after 5 days of treatment,BV and BF in the observation group were significantly higher than those in the control group,and PS was significantly lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion:The application of early continuous blood purification in patients with severe acute pancreatitis has a good effect,and can significantly improve serological indexes,pancreatic microcirculation,reduce inflammatory response,and promote early recovery

关 键 词：早期连续性血液净化 重症急性胰腺炎 胰腺微循环 

分 类 号：R576[医药卫生—消化系统]