论文部分内容阅读
目的观察床边血浆置换治疗重症高脂血症性急性胰腺炎的临床疗效。方法确诊为重症高脂血症性急性胰腺炎的60例患者分为治疗组(29例)和对照组(31例),观察床边血浆置换的疗效性及安全性。结果治疗组腹痛缓解时间、腹胀缓解时间及住院时间明显短于对照组,差异有统计学意义(P<0.05);两组APACHEⅡ评分较治疗前均下降,但两组治疗后4 d APACHEⅡ评分比较差异有统计学意义(P<0.05);两组治疗后血淀粉酶较治疗前有所下降,但均无统计学意义(P>0.05);治疗后第6天,两组TG、TNF-α、IL-6水平均较治疗前降低,但差异仅治疗组与同组治疗前比较、与对照组治疗后比较差异均有统计学意义(P<0.05)。治疗组在接受血浆置换治疗时出现2例低血压、1例荨麻疹,经对症治疗后好转。结论床边血浆置换能使高脂血症性急性胰腺炎(HLAP)患者受益,且安全有效,值得临床推广。
Objective To observe the clinical effect of bedside plasma exchange in the treatment of severe acute hyperlipidemic acute pancreatitis. Methods Sixty patients diagnosed as having severe hyperlipidemic acute pancreatitis were divided into treatment group (n = 29) and control group (n = 31). The curative effect and safety of bedside plasma exchange were observed. Results The pain relieving time, abdominal distension time and hospitalization time in the treatment group were significantly shorter than those in the control group (P <0.05). APACHEⅡscore decreased in both groups before and after treatment, but APACHEⅡscore in the two groups after 4 days of treatment The difference was statistically significant (P <0.05); after treatment, serum amylase in both groups decreased compared with before treatment, but there was no statistical significance (P> 0.05); on the 6th day after treatment, TG and TNF- , IL-6 levels were lower than those before treatment, but the differences were only significant difference between the treatment group and the control group after treatment (P <0.05). The treatment group received 2 cases of hypotension and 1 case of urticaria when receiving plasma exchange therapy, which improved after symptomatic treatment. Conclusion Bedside plasma exchange can benefit patients with hyperlipidemic acute pancreatitis (HLAP) and is safe and effective, which is worthy of clinical promotion.