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目的探讨应用连续血液净化疗法在救治重症急性胰腺炎中的作用。方法选择重症急性胰腺炎患者12例,在常规治疗基础上,加用连续血液净化疗法,即连续静-静脉血液滤过(CVVH)治疗,采用前稀释法补充置换液,治疗12～72 h/次,平均46.3 h后更换滤器,根据病情持续治疗2～6 d不等,置换液流量2000～4000 ml/h,血流量150～300 ml/min,采用普通肝素抗凝。结果 12例患者中11例好转,1例放弃治疗死亡,死亡患者系对放弃治疗者随访证实。结论连续血液净化疗法在重症急性胰腺炎患者治疗过程中对血流动力学稳定,改善患者的内环境起重要作用,是治疗重症急性胰腺炎的有效措施之一。
Objective To explore the application of continuous blood purification in the treatment of severe acute pancreatitis. Methods Twelve patients with severe acute pancreatitis were selected. On the basis of conventional therapy, continuous blood purification (CVT) was used to treat CVS, and replacement fluid was replaced by pre-dilution. After 12-7 h / Times, an average of 46.3 h after the replacement filter, according to the condition of continuous treatment of 2 ~ 6 d range, replacement fluid flow 2000 ~ 4000 ml / h, blood flow 150 ~ 300 ml / min, unfractionated heparin anticoagulation. Results Of the 12 patients, 11 improved, 1 gave up the treatment of death, the death of patients to give up the treatment were followed up confirmed. Conclusion Continuous blood purification therapy plays an important role in the stabilization of hemodynamics and the improvement of patients’ internal environment during the treatment of severe acute pancreatitis, and is one of the effective measures for the treatment of severe acute pancreatitis.