摘要
目的探讨血液灌流联合持续性血液净化治疗对重症急性胰腺炎(SAP)伴全身炎症反应综合征(SIRS)患者的临床疗效、炎性因子和预后影响。方法选取2015年1月-2018年1月收治的SAP伴SIRS患者54例,根据治疗方案不同分为观察组30例和对照组24例,对照组给予常规西医治疗,观察组在对照组基础上给予血液灌流联合持续性血液净化治疗。比较2组患者的临床疗效、炎性因子表达水平、临床指标及急性生理学与慢性健康状况Ⅱ(APACHEⅡ)评分。结果观察组总有效率高于对照组(P<0.05)。2组治疗后72 h炎性因子[肿瘤坏死因子-α、白介素-6、超敏C反应蛋白、降钙素原]及甘油三酯水平均较治疗前降低,且观察组低于对照组(P<0.05)。治疗后72 h,2组患者体温、心率、呼吸及白细胞计数均较治疗前降低,且观察组低于对照组(P<0.05),平均动脉压、氧合指数较治疗前升高,且观察组高于对照组(P<0.05)。治疗后72 h,2组APACHEⅡ评分均较治疗前降低,且观察组低于对照组(P<0.05)。结论血液灌流联合持续性血液净化治疗SAP伴SIRS患者,较常规西医治疗临床效果更高,病死率更低,可明显降低血清炎性因子表达水平;改善患者临床指标,降低其APACHEⅡ评分并改善预后。
Objective To investigate the clinical effects of hemoperfusion combined with continuous blood purification(CBP) on patients with severe acute pancreatitis(SAP) combined with systemic inflammatory response syndrome(SIRS), and their effect on inflammatory factors and prognosis. Methods Fifty-four patients with SAP and SIRS admitted during January 2015 and January 2018 were divided into observation group(n=30) and control group(n=24) according to different treatment plans. The control group was treated with conventional western medicine, while the observation group was supplemented with hemoperfusion combined with CBP. The clinical efficacy, inflammatory factor expression levels, clinical indicators, and acute physiology and chronic health status II(APACHE II) scores were compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group(P<0.05). At 72 h after treatment, the levels of inflammatory factors(Tumor necrosis factor-α, Interleukin-6, high-sensitivity C-reactive protein, procalcitonin) and triacylglycerol in the two groups were lower, which were significantly lower in the observation group than in the control group(P<0.05). At 72 h after treatment, the body temperature, heart rate, respiration and WBC count of the two groups were lower than those before treatment, which was lower in the observation group than in the control group, and the average arterial pressure, oxygenation index of the observation group were higher, which were higher in the observation group than in the control group(P<0.05). At 72 h after treatment, the APACHE Ⅱ scores of the two groups were lower than those before treatment, which were lower in the observation group than in the control group(P<0.05). Conclusion Compared with conventional Western medicine, hemoperfusion combined with CBP has better clinical efficacy and lower mortality in the treatment of SAP combined with SIRS. It can significantly reduce the expression level of serum inflammatory factors, improve t
作者
舒艾娅
符宜龙
简万均
唐中建
SHU Ai-ya;FU Yi-long;JIAN Wan-jun;TANG Zhong-jian(Department of Critical Care Medicine,Fuling Central Hospital,Chongqing 408000,China)
出处
《解放军医药杂志》
CAS
2020年第5期82-85,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
重庆市卫生和计划生育委员会医学科研计划项目(20152214)。
关键词
重症急性胰腺炎
血液灌流
持续性血液净化
全身炎症反应综合征
肿瘤坏死因子-α
白介素-6
预后
Severe acute pancreatitis
Hemoperfusion
Persistent blood purification
Systemic inflammatory response syndrome
Tumor necrosis factor-α
Interleukin-6
Prognosis
