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目的 探讨早期呼吸机支持加床边血液滤过治疗急性重症胰腺炎合并急性肺损伤的效果。方法 对 17例急性重症胰腺炎合并急性肺损伤患者 2 4h内行呼吸机支持 ,并行床边静脉 静脉血液滤过 (CVVH )、肠外营养 (TPN)和控制感染 ,监测动脉血氧分压 (PaO2 )、氧合指数(PaO2 /FiO2 )、中心静脉压 (CVP)、血肌酐 (Cr)、血尿素氮 (BUN)和丙氨酸氨基转移酶 (ALT)。结果与对照组比较 ,治疗组PaO2 和PaO2 /FiO2 均有明显提高 (P <0 0 5) ,Cr和BUN有所下降 (P <0 0 5) ,乳酸值未见明显增高 ,肺顺应性 (Cst)稳定在 3 1~ 3 4ml/cmH2 O。结论 早期呼吸机支持加床边血液滤过对维护急性重症胰腺炎合并肺损伤患者的重要脏器功能具有重要意义。
Objective To investigate the effect of early ventilator supporting bedside hemofiltration in the treatment of acute severe pancreatitis complicated by acute lung injury. Methods 17 patients with acute severe pancreatitis complicated with acute lung injury were ventilated for 24 hours with parallel bedside venous hemofiltration (CVVH), parenteral nutrition (TPN) and infection control. The arterial oxygen pressure (PaO2 PaO2 / FiO2, CVP, Cr, BUN and ALT were measured. Results Compared with the control group, PaO2 and PaO2 / FiO2 in the treatment group were significantly increased (P <0 05), Cr and BUN decreased (P 0 05), lactate value was not significantly increased, lung compliance Cst) stabilized at 31 ~ 3 4ml / cmH2O. Conclusion Early ventilator support bedside hemofiltration is important for the maintenance of important organ function in patients with acute severe pancreatitis complicated with lung injury.