床旁连续血液净化治疗急性重症胰腺炎的临床疗效观察  

Clinical efficacy observation of bedside continuous blood purification treatment for acute severe pancreatitis

作　　者：叶倩雅 李倩倩 Ye Qian-ya;Li Qian-qian(Department of Emergency Internal Medicine,Nanyang Central Hospital,Nanyang 473000,Henan,China)

机构地区：[1]南阳市中心医院急诊内科,河南南阳473000

出　　处：《四川生理科学杂志》2025年第4期926-929,共4页

摘　　要：目的:探究床旁连续血液净化治疗急性重症胰腺炎的效果。方法:选择2022年7月至2024年7月我院收治的94例急性重症胰腺炎患者作为研究对象,以随机数字表法分为观察组和对照组,各47例。对照组采用常规治疗,观察组在对照组的基础上加用床旁连续血液净化治疗。比较两组临床疗效、急性生理与慢性健康评分系统(Acute Physiology and Chronic Health Evaluation,APACHEⅡ)评分、生化指标[血清淀粉酶(Amylase,AMS)、血清肌酐(SerumCreatinine,SCR)、尿素氮(Blood Urea Nitrogen,BUN)、谷丙转氨酶(Alanine Aminotransferase,ALT)]、炎症因子[白细胞介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、降钙素原(Procalcitonin,PCT)]及免疫功能指标[免疫球蛋白G(Immunoglobulin G,IgG)、免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白M(Immunoglobulin M,IgM)]。结果:观察组治疗总有效率明显高于对照组(P<0.05)。治疗前,两组APACHEⅡ评分、AMS、SCR、BUN、ALT、IL-6、CRP、TNF-α、PCT、IgG、IgA和IgM无明显差异(P>0.05)。治疗后,两组APACHEⅡ评分显著降低,且观察组显著低于对照组(P<0.001);两组AMS、SCR、BUN、ALT、IL-6、CRP、TNF-α和PCT均明显降低,且观察组明显低于对照组(P<0.05);两组IgG、IgA和IgM均明显升高,且观察组明显高于对照组(P<0.05)。结论:急性重症胰腺炎患者采用床旁连续血液净化治疗效果较好,可有效抑制炎症反应,调节免疫功能与生化指标,促进患者转归,值得临床推广。Objective:To explore the effect of bedside continuous blood purification therapy on acute severe pancreatitis.Methods:A total of 94 patients with acute severe pancreatitis admitted to our hospital were selected from July 2022 to July 2024 as research subjects.They were divided into an observation group and a control group,with 47 cases in each group,using a random number table method.The control group received conventional treatment,while the observation group received bedside continuous blood purification therapy in addition to the treatment received by the control group.The clinical efficacy,Acute Physiology and Chronic Health Evaluation II(APACHE II)scores,biochemical indicators[serum amylase(AMS),serum creatinine(SCR),blood urea nitrogen(BUN),alanine aminotransferase(ALT)],inflammatory factors[interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-alpha(TNF-α),procalcitonin(PCT)],and immune function indicators[immunoglobulin G(IgG),immunoglobulin A(IgA),immunoglobulin M(IgM)]were compared between the two groups.Results:The overall effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.05).Before treatment,there were no significant differences between the two groups in APACHE II scores,AMS,SCR,BUN,ALT,IL-6,CRP,TNF-α,PCT,IgG,IgA,and IgM(P>0.05).After treatment,the APACHE II scores of both groups were significantly reduced,with the observation group being significantly lower than the control group(P<0.001).The levels of AMS,SCR,BUN,ALT,IL-6,CRP,TNF-α,and PCT in both groups were significantly decreased,with the observation group showing significantly lower levels than the control group(P<0.05).The levels of IgG,IgA,and IgM in both groups were significantly increased,with the observation group being significantly higher than the control group(P<0.05).Conclusion:Continuous bedside blood purification therapy is effective in treating patients with acute severe pancreatitis,which can effectively inhibit inflammatory reactions,regulate immune funct

关 键 词：急性重症胰腺炎 床旁连续血液净化 生化指标 炎症因子 免疫功能 

分 类 号：R576[医药卫生—消化系统]