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目的:探讨连续性血液净化治疗重症急性胰腺炎的临床疗效及安全性。方法:选取60例重症急性胰腺炎患者并随机分为两组,观察组(31例)给予连续血液净化治疗,对照组(29例)给予常规治疗。检测盒比较两组治疗前后C反应蛋白(CRP)、谷丙转氨酶(ALT)、氧合指数(PaO_2/FiO_2)、碳酸氢根离子(HCO_3~-)、血肌酐(Scr)水平、急性生理与慢性健康评分(APACHEⅡ)和多器官功能障碍综合征评分(MODS评分)及治疗期间并发症的发生情况和存活情况。结果:治疗后,两组CRP、ALT、HCO3~-、Scr水平均明显下降,PaO_2/FiO_2水平明显升高(P<0.05),且观察组CRP、ALT、HCO_3~-、Scr水平低于对照组,而PaO_2/FiO_2水平高于对照组(P<0.05)。治疗后,两组APACHEⅡ和MODS评分均较治疗前有所下降,且观察组分值明显低于对照组(P<0.05)。两组治疗期间并发症发生率和存活率比较差异无统计学意义(P>0.05)。结论:连续性血液净化治疗对重症急性胰腺炎具有较好的治疗效果,能显著改善多器官功能,降低体内炎症反应,调节水电解质平衡,治疗具有较高的安全性。
Objective: To investigate the clinical efficacy and safety of continuous blood purification in the treatment of severe acute pancreatitis. Methods: Sixty patients with severe acute pancreatitis were selected and divided into two groups at random. The observation group (31 cases) was given continuous blood purification treatment and the control group (29 cases) were given routine treatment. The levels of C reactive protein (CRP), alanine aminotransferase (ALT), oxygenation index (PaO 2 / FiO 2), bicarbonate ion (HCO 3 -) and serum creatinine (Scr) Chronic health score (APACHE Ⅱ) and multiple organ dysfunction syndrome score (MODS score) and the occurrence of complications and survival during treatment. Results: After treatment, the levels of CRP, ALT, HCO3 - and Scr in both groups were significantly decreased and the levels of PaO_2 / FiO_2 were significantly increased (P <0.05), and the levels of CRP, ALT, HCO 3 - and Scr in the observation group were lower than those in the control Group, while the PaO 2 / FiO 2 level was higher than that of the control group (P <0.05). After treatment, APACHE Ⅱ and MODS scores of both groups were lower than those before treatment, and the values of the observed components were significantly lower than those of the control group (P <0.05). There was no significant difference in complication rates and survival between the two groups (P> 0.05). CONCLUSION: Continuous blood purification has a good therapeutic effect on severe acute pancreatitis. It can significantly improve the function of multiple organs, reduce the inflammatory reaction in vivo and regulate the electrolyte balance. The treatment has high safety.