摘要
目的观察在重症急性胰腺炎患者中应用连续性血液净化联合清胰利胆颗粒方案,对其生化指标、炎性指标及治疗效果的影响.方法回顾性分析2012-04/2017-04浙江绍兴第二医院收治的150例重症急性胰腺炎患者的临床资料,其中70例患者给予在常规治疗基础上给予连续性血液净化方案,将其作为对照组,80例患者在常规治疗基础上给予连续性血液净化联合清胰利胆颗粒方案,将其作为观察组.然后将两组患者的生化指标、炎性指标、APACHEⅡ评分、CTSI评分及治疗效果等进行比较.结果在治疗后,观察组患者的APACHEⅡ评分明显低于对照组(10.22分±2.58分vs 14.03分±2.91分),差异均具有统计学意义(P<0.05);在治疗后,观察组患者的腹胀消失时间、腹痛消失时间、住院时间明显低于对照组,差异均具有统计学意义(P<0.05);在治疗后,观察组患者的血清淀粉酶、血清脂肪酶、肌酐、谷草转氨酶、谷丙转氨酶、降钙素原明显低于对照组,差异均具有统计学意义(P<0.05);在治疗后,观察组患者的白介素(interleukin,IL)-8、IL-6、肿瘤坏死因子-α、热休克蛋白70、HSP72、高迁移率族蛋白1值明显低于对照组,差异均具有统计学意义(P<0.05);经过治疗后,观察组患者的治疗总有效率明显高于对照组(93.75%vs 71.43%),差异有统计学意义(P<0.05);对照组患者的死亡率为8.57%,观察组患者的死亡率为6.25%,差异无统计学意义;对照组患者的并发症发生率明显高于对照组(28.57%vs12.5%),差异具有统计学意义(P<0.05).结论在重症急性胰腺炎患者中应用连续性血液净化联合清胰利胆颗粒的治疗方案,能够显著减轻患者的炎性反应,改善患者的生化指标,提高治疗效果.
AIM To observe the effect of continuous blood purification combined with Qingyi Lidan granules in patients with severe acute pancreatitis with regard to biochemical indexes, inflammatory indexes, and therapeutic effects. METHODS The clinical data of 150 patients with severe acute pancreatitis treated at Shaoxing Second Hospital from April 2012 to April 2017 were retrospectively analyzed. Among them, 70 patients were given continuous blood purification therapy as a control group, and the other 80 patients were given continuous blood purification combined with Qingyi Lidan granules based on conventional therapy, as an observation group. Biochemical indicators, inflammatory indicators, APACHE II score, CTSI score, and therapeutic effects were compared between the two groups. After treatment, APACHE II score was significantly lower in the observation group than in the control group （10.22 ± 2.58 vs 14.03 ± 2.91, P 〈 0.05）. The time to disappearance of abdominal distension and abdominal pain and hospital stay were significantly shorter in the observation group than in the control group （P 〈 0.05）. AMS, LPS, Cr, AST, ALT, and PCT in the observation group were significantly lower than those in the control group （P 〈 0.05）. The levels of IL-8, IL-6, TNF-α, HSP70, HSP72, and HMGB1 in the observation group were also significantly lower than those in the control group （P 〈 0.05）. The total effective rate was significantly higher in the observation group than in the control group （93.75% vs 71.43%, P 〈 0.05）. The mortality rate did not differ significantly between the control group and observation group （8.57% vs 6.25%）. The incidence of complications in the control group was significantly higher than that of the observation group （28.57% vs 12.5%, P 〈 0.05）.CONCLUSION Continuous blood purification combined with Qingyi Lidan granules in patients with severe acute pancreatitis can significantly reduce the inflammatory response and improve biochemical indexes and therapeutic effects.
作者
梁英英
黄兰芳
王金英
Ying-Ying Liang;Lan-Fang Huang;Jin-Ying Wang(Department of ICU Nursing, Shaoxing Second Hospital, Shaoxing 312000, Zhejiang Province, China)
出处
《世界华人消化杂志》
CAS
2018年第12期735-741,共7页
World Chinese Journal of Digestology
关键词
胰腺炎
重症
连续性血液净化
清胰利胆颗粒
Pancreatitis
Severe
Continuous bloodpurification
Qingyi Lidan granules
