摘要
目的:探讨血浆置换辅助日间连续性血液净化(Daytime continuous renal replacement therapy,DCRRT)治疗重症急性胰腺炎(Severe acute pancreatitis,SAP)患者的预后研究。方法:回顾性选取2017年6月至2020年6月于我院确诊的106例SAP患者,根据其治疗方案分为观察组(n=53)与对照组(n=53);对照组均单独采用DCRRT治疗,观察组在对照组的基础上均添加血浆置换。治疗21d后,评估两组治疗效果和急性生理与慢性健康评分(Acute physiology and chronic health evaluation-II,APACHE-II);治疗前、治疗21 d后,采用全自动生化分析仪检测血清甘油三脂(Triacylglycerol,TG)、总胆固醇(Total cholesterol,TC)和血清淀粉酶(Serum amylase,AMS)、血清脂肪酶(Serum lipase,LPS)水平;采用血常规分析仪检测白细胞计数(White blood cell count,WBC);采用酶联吸附法检测C反应蛋白(C-reactive protein,CRP)、降钙素原(Procalcitonin,PCT);记录两组治疗期间不良事件发生率。结果:观察组SAP患者的有效率高于对照组(P<0.05)。与治疗前相比,两组患者AMS、LPS、TC与TG均明显降低(P<0.05),两组CRP、WBC、PCT水平与APACHE-II评分也有明显降低(P<0.05);观察组下降更为显著(P<0.05)。观察组的总不良事件发生率显著低于对照组(P<0.05)。结论:血浆置换辅助DCRRT可以降低SAP患者血清AMS和炎症反应,提高疗效,降低不良事件发生率。
Objective:To explore the prognosis of patients with severe acute pancreatitis(SAP)treated with daytime continuous renal replacement therapy(DCRRT)assisted with plasma exchange.Methods:A total of 106 patients with SAP confirmed in the hospital were retrospectively enrolled between June 2017 and June 2020.According to different treatment methods,they were divided into observation group(n=53)and control group(n=53).The control group was treated with DCRRT,while observation group was additionally treated with plasma exchange.After 21d of treatment,curative effect and scores of acute physiology and chronic health evaluation II(APACHE-II)in both groups were evaluated.Before and after 21d of treatment,levels of serum triacylglycerol(TG),total cholesterol(TC),serum amylase(AMS)and lipase(LPS)were detected by full-automatic biochemical analyzer.The white blood cell count(WBC)was detected by routine blood analyzer.C-reactive protein(CRP)and procalcitonin(PCT)were detected by enzyme-linked immunosorbent assay.The incidence of adverse events during treatment was recorded.Results:The response rate of SAP patients in observation group was higher than that in control group(P<0.05).After treatment,AMS,LPS,TC and TG were significantly decreased in both groups(P<0.05),CRP,WBC,PCT levels and APACHE-II scores were also significantly decreased in both groups(P<0.05).The decrease of the above indexes in observation group was more significant(P<0.05).The total incidence of adverse events in observation group was significantly lower than that in control group(P<0.05).Conclusion:Plasma exchange assisted DCRRT can reduce AMS and inflammatory response in SAP patients,improve curative effect and reduce the incidence of adverse events.
作者
姬杏丹
Ji Xing-Dan(Department of Nephrology,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,China)
出处
《四川生理科学杂志》
2022年第4期574-576,752,共4页
Sichuan Journal of Physiological Sciences
关键词
日间连续性血液净化
血浆置换
重症胰腺炎
预后
Daytime continuous renal replacement therapy
Plasma exchange
Severe pancreatitis
Prognosis
