發(fā)布時(shí)間：2018-05-29 02:07

  本文選題：血液凈化 + 血液濾過　； 參考：《重慶醫(yī)學(xué)》2015年18期

【摘要】：目的探討聯(lián)合血液凈化(CBP)治療對(duì)重癥急性胰腺炎(SAP)患者炎癥因子和療效的影響。方法 82例SAP患者分為對(duì)照組42例和CBP組40例,對(duì)照組采用常規(guī)綜合治療方法,CBP組在對(duì)照組治療基礎(chǔ)上加用血液濾過聯(lián)合血液灌流治療。比較兩組患者治療前及治療72h后生命體征、炎癥因子、急性生理學(xué)與慢性健康狀況評(píng)分(APACHEⅡ評(píng)分)變化;記錄兩組患者臨床癥狀如腹脹、腹痛等消失的時(shí)間、體溫恢復(fù)時(shí)間、腸蠕動(dòng)恢復(fù)時(shí)間、血淀粉酶恢復(fù)時(shí)間、住院時(shí)間及血液凈化過程中出現(xiàn)的不良反應(yīng)。結(jié)果治療72h后兩組患者的生命體征(T、HR、RR、MAP)、OI、TG及炎癥因子水平(TNF-α、IL-6、hs-CRP、PCT)均較治療前有顯著改善(P0.05),而CBP組患者M(jìn)AP、OI、TG及炎癥因子水平(TNF-α、IL-6、hs-CRP、PCT)較對(duì)照組改善更顯著(P0.01);CBP組的癥狀消失時(shí)間、體溫恢復(fù)時(shí)間、腸蠕動(dòng)恢復(fù)時(shí)間、血淀粉酶恢復(fù)時(shí)間及住院時(shí)間均明顯短于對(duì)照組(P0.01);CBP組的治愈率高于對(duì)照組(P0.05),病死率低于對(duì)照組(P0.05);CBP的不良反應(yīng)輕微。結(jié)論在常規(guī)綜合治療基礎(chǔ)上,CBP治療能更有效地提高OI和APACHEⅡ評(píng)分,加快病情恢復(fù),縮短住院時(shí)間,其機(jī)制可能與更有效地清除體內(nèi)炎癥介質(zhì)和血脂有關(guān)。
[Abstract]:Objective to investigate the effect of combined blood purification therapy (CBP) on inflammatory factors in patients with severe acute pancreatitis (SAP). Methods Eighty-two patients with SAP were divided into control group (n = 42) and CBP group (n = 40). The changes of vital signs, inflammatory factors, acute physiology and chronic health status were compared before and 72 hours after treatment, and the clinical symptoms such as abdominal distension and abdominal pain were recorded, and the recovery time of body temperature was recorded. Intestinal peristalsis recovery time, blood amylase recovery time, hospitalization time and adverse reactions during blood purification. Results after 72 hours of treatment, the vital signs and the levels of TNF- 偽 IL-6hs-CRPnc-PCT in the two groups were significantly improved compared with those before treatment, while in the CBP group, the levels of TNF- 偽 IL-6hs-CRPPCT were improved more significantly than those of the control group, and the time of disappearance of symptoms and the time of recovery of body temperature were significantly improved compared with those of the control group, while the levels of TNF- 偽 IL-6hs-CRPPnhs-CRPPCT in the CBP group were significantly improved compared with those in the control group, and the recovery time of body temperature in the two groups was much higher than that in the control group, and that in the CBP group was significantly higher than that in the control group. The recovery time of intestinal peristalsis, the recovery time of blood amylase and the time of hospitalization were significantly shorter than those of the control group (P 0.01). The cure rate of CBP group was higher than that of control group (P 0.05), and the fatality rate was lower than that of control group (P 0.05). Conclusion on the basis of routine comprehensive therapy, CBP can effectively improve the scores of OI and APACHE 鈪，

本文編號(hào)：1949085