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目的研究连续血液净化治疗(CBP)配合护理对ICU中重症急性胰腺炎的治疗效果。方法收集本院2012年1月至2016年3月ICU收治的38例确诊为重症急性胰腺炎的患者作为研究对象,收集临床资料,在常规治疗的基础上采用连续性血液净化配合护理干预,记录治疗前后患者的体温、血压、心率等生命体征,并进行APACHEⅡ评分,对比观察治疗前后患者血清淀粉酶、肝肾功能、动脉血气分析等指标,判断病情变化。结果 38例患者治愈出院34例,死亡4例,存活率为89.5%,死亡原因均为多器官功能衰竭。治愈患者在CBP配合护理治疗后,各项临床指标有明显改善,APACHEⅡ评分降低,血清总胆红素(TB)、淀粉酶(AMS)等相比治疗前下降,代谢性酸中毒(pH值和HCO3-浓度)发生明显改善,差异均有统计学意义(P<0.05)。结论 CBP配合ICU护理治疗重症急性胰腺炎患者取得了满意的临床治疗效果,护理配合在临床治疗中尤为重要。
Objective To study the therapeutic effect of continuous blood purification (CBP) with intensive care on severe acute pancreatitis in ICU. Methods A total of 38 patients diagnosed as severe acute pancreatitis admitted to ICU from January 2012 to March 2016 in our hospital were enrolled in this study. Clinical data were collected and continuous blood purification combined with nursing intervention was used on the basis of routine treatment. The body temperature, blood pressure, heart rate and other vital signs before and after treatment were measured. The APACHEⅡscore was compared with the changes of serum amylase, liver and kidney function and arterial blood gas analysis before and after treatment. Results 38 patients were cured and discharged in 34 cases, 4 patients died, the survival rate was 89.5%, the causes of death were multiple organ failure. After treatment with CBP, the clinical parameters of the cured patients were significantly improved, APACHEⅡscore decreased, serum total bilirubin (TB) and amylase (AMS) decreased compared with before treatment, metabolic acidosis (pH and HCO3-concentration) significantly improved, the difference was statistically significant (P <0.05). Conclusion CBP with ICU nursing patients with severe acute pancreatitis have achieved satisfactory results in clinical treatment, nursing cooperation is particularly important in clinical treatment.