摘要
目的探讨早期短时间连续肾脏替代治疗(CRRT)进行血液滤过对重症急性胰腺炎(SAP)并发急性呼吸窘迫综合症(ARDS)患者呼吸循环及外周血血清细胞因子水平的影响。方法随机选取54例确诊SAP且发病72h内进入ICU后并发ARDS而接受呼吸机治疗、血液滤过治疗患者,于CRRT治疗前、治疗后6h、12h、24h相应时间点抽取动脉血做血气分析并留取血样测血清细胞因子肿瘤坏死因子(TNF-α)、白介素-4(IL-4)、白介素-6(IL-6)浓度及C反应蛋白(CRP)的变化,记录气道峰压、肺顺应性和血气结果。结果 CRRT治疗后6h、12h、24h患者动脉血氧分压、氧合指数和肺动态顺应性有明显升高,气道峰压明显降低,血清炎症细胞因子、C反应蛋白明显下降,差异均有统计学意义(P<0.05)。结论 CRRT能降低炎症介质,改善呼吸循环功能。
Objective To explore the effects of early short-time continuous renal replacement therapy（CRRT） on the respiration and blood circulation as well as peripheral blood serum cytokines level in the patients with severe acute pancreatitis （SAP） complicated by acute respiratory distress syndrome （ARDS）. Methods Fifty four patients with SAP complicated by ARDS, who had been admitted into ICU within the first 72 h after onset and treated with respirator and CRRT,were involved in this study. At the time before CRRT and 6,12,24 h after CRRT, the arterial blood was sampled for arterial blood gas analysis and kept for de- termining the change of serum cytokines （TNF-α, IL-4, IL-6） and CRP level. In the meantime, peak inspiratory pressure and lung compliance were recorded. Results Just at 6,12,24 h after CRRT, the patients＇ arterialpartial pressure of oxygen（ PaO2 ） ,oxy- genation index and lung compliance increased ; Meanwhile, the peak inspiratory pressure, level of serum cytokines and CRP decreased significantly （P 〈 0.05 ）. Conclusion CRRT can decrease the level of inflammatory factors and improve the function of circulation and respiration.
出处
《中华全科医学》
2010年第12期1520-1521,共2页
Chinese Journal of General Practice
关键词
血液滤过
重症急性胰腺炎
ARDS
Continuous renal replacement therapy
Severe acute pancreatitis
Acute respiratory distress syndrome
