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目的:探讨连续性血液净化(CBP)对急性胰腺炎(AP)的治疗效果及预后的影响。方法:选取2010年1月至2016年12月间我院1200例AP患者作为研究对象,按照随机数字表法分为常规治疗组及CBP治疗组,每组600例。常规治疗组接受常规药物治疗,CBP治疗组在常用药物治疗的基础上联合应用CBP治疗。对比治疗后两组患者临床症状消失时间以及治疗前、治疗后72h炎性因子水平变化情况和肠道功能变化情况,并对比两组治疗后7 d的死亡率。结果:CBP治疗组治疗后的腹痛消失时间、腹胀消失时间及腹部压痛消失时间均低于常规治疗组(P<0.05)。两组治疗前内毒素、C反应蛋白(CRP)、淀粉酶(AMS)、二胺氧化酶及丙二醛比较无统计学差异(P>0.05);治疗后72 h,内毒素、CRP、AMS、二胺氧化酶及丙二醛水平均较治疗前降低,且CBP治疗组低于常规治疗组(P<0.05)。治疗后7 d CBP治疗组死亡率低于常规治疗组,差异具有统计学意义(P<0.05)。结论:CBP可有效的提高AP的临床治疗效果,并改善患者的临床预后。
Objective: To investigate the effect of continuous blood purification (CBP) on the treatment and prognosis of acute pancreatitis (AP). Methods: One hundred and twenty patients with AP in our hospital from January 2010 to December 2016 were selected as the research object. According to the random number table, they were divided into conventional treatment group and CBP treatment group, with 600 cases in each group. The conventional treatment group received routine drug treatment, CBP treatment group on the basis of commonly used drugs combined with CBP treatment. The time of disappearance of clinical symptoms, the changes of inflammatory cytokines at 72h after treatment and the changes of intestinal function were compared between the two groups after treatment, and the mortality of the two groups after 7 days of treatment was compared. Results: The disappearance of abdominal pain, disappearance of abdominal distension and disappearance of abdominal tenderness in CBP treatment group were lower than those in the conventional treatment group (P <0.05). There was no significant difference in endotoxin, C-reactive protein (CRP), amylase (AMS), diamine oxidase and malondialdehyde between the two groups before treatment (P> 0.05) , Diamine oxidase and malondialdehyde levels were lower than before treatment, and the CBP treatment group was lower than the conventional treatment group (P <0.05). The mortality rate of CBP group was lower than that of routine treatment group on the 7th day after treatment, the difference was statistically significant (P <0.05). Conclusion: CBP can effectively improve the clinical efficacy of AP and improve the clinical prognosis of patients.