摘要
目的探讨血液滤过治疗对重症急性胰腺炎合并腹腔间隔室综合征患者生化指标、肝肾功能、炎症因子水平的影响。方法回顾性分析2017年5月至2021年5月西部战区总医院收治的急性胰腺炎合并腹腔间隔室综合征患者的临床资料,依据治疗方式的不同对纳入的研究对象进行分组,采用血液滤过治疗的患者为血液滤过组(n=58),采用常规对症治疗的患者为常规对症组(n=56)。比较两组患者治疗后各临床症状改善时间、生化指标、肝肾功能指标以及炎症因子水平。结果血液滤过组腹胀缓解时间、腹痛缓解时间、肠鸣音缓解时间、腹膜刺激征缓解时间、住院时间(4.49±1.13)、(3.21±0.57)、(5.84±1.22)、(3.23±0.45)、(13.69±2.85)d,均短于常规对症组[(7.58±1.28)、(5.38±0.68)、(8.67±1.41)、(6.58±1.13)、(20.16±2.91)d],差异均有统计学意义(P<0.05)。血液滤过组治疗后1、2周的脂肪酶、血淀粉酶、肌酐、尿素氮、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、C反应蛋白、白细胞介素-6水平均明显低于常规对症组,差异均有统计学意义(P<0.05)。结论对重症急性胰腺炎合并ACS患者实施血液滤过治疗利于稳定肝肾功能,减轻炎症因子表达,改善预后。
Objective To investigate the effects of hemofiltration on biochemical indexes,liver and kidney function and inflammatory factors in patients with severe acute pancreatitis complicated with abdominal compartment syndrome.Methods The clinical data of patients with acute pancreatitis and peritoneal septum syndrome admitted to Western Theater General Hospital from May 2017 to May 2021 were retrospectively analyzed.According to the different treatment methods,the included research subjects were divided into groups.The patients who received hemofiltration treatment were the hemofiltration group(n=58),and the patients who received conventional symptomatic treatment were the conventional symptomatic group(n=56).The improvement time of clinical symptoms,biochemical indexes,liver and kidney function indexes and the level of inflammatory factors were compared between the two groups.Results The abdominal distension relief time,abdominal pain relief time,bowel sounds relief time,peritoneal irritation relief time,hospital stay in the blood filtered group were(4.49±1.13),(3.21±0.57),(5.84±1.22),(3.23±0.45),(13.69±2.85)d,which were shorter than those in the conventional symptomatic group[(7.58±1.28),(5.38±0.68),(8.67±1.41),(6.58±1.13),(20.16±2.91)d],the differences were statistically significant(P<0.05).The levels of lipase,blood amylase,creatinine,urea nitrogen,alanine aminotransferase,aspartate aminotransferase,C-reactive protein,and interleukin-6 levels in the hemofiltration group 1 and 2 weeks after treatment were significant lower than those in the conventional symptomatic group,the differences were statistically significant(P<0.05).Conclusion Hemofiltration therapy for patients with severe acute pancreatitis combined with ACS is beneficial to stabilize liver and kidney function,reduce inflammatory factors,and improve prognosis.
作者
王萍
李乐
兰东
王实朴
吴晓玲
WANG Ping;LI Le;LAN Dong(Department of Emergency Medicine,Western Theater General Hospital,Chengdu Sichuan 610083,China)
出处
《临床和实验医学杂志》
2022年第4期384-388,共5页
Journal of Clinical and Experimental Medicine
基金
四川省卫生和计划生育委员会科研课题项目(编号:20PJ179)。
关键词
重症急性胰腺炎
腹腔间隔室综合征
血液滤过
肝肾功能
炎症因子
Severe acute pancreatitis
Abdominal compartment syndrome
Hemofiltration
Liver and kidney function
Inflammatory factors
