摘要
摘要目的探讨连续性肾脏替代联合血液灌流对急性重症胰腺炎患者炎症因子的影响.方法选取２０１１年９月－２０１４年１０月我院收治的急性重症胰腺炎患者６０例,将其分为观察组和对照组,各３０例.对照组患者给予连续性肾脏替代治疗(CRRT),观察组患者给予CRRT联合血液灌流治疗.观察两组患者治疗前后的炎症细胞因子变化及急性生理与慢性健康(APACHE－II)评分.结果治疗前两组患者的APACHE－II评分无显著性差异(P＝０．５０１);治疗后(治疗后５天和治疗后１０天)观察组的评分显著高于对照组(P均＝０．０００).治疗前两组患者的IL－６、IL－８及TNF－α水平无显著性差异(P均＞０．０５);治疗后观察组患者的炎症因子水平明显低于对照组(P均＝０．０００).结论连续性肾脏替代联合血液灌流治疗能显著提高急性重症胰腺炎患者的APACHE－II评分,降低其炎症因子水平,临床疗效显著.关键词连续性肾脏替代;血液灌流;急性重症胰腺炎;炎症因子EffectofcontinuousrenalreplacementcombinedwithbloodperfusiononinflammatoryfactorsinpatientswithsevereacutepancreatitisDepartmentofIntensivecareunit,ThesecondhospitalAffiliatedtoJangHanuniversity．Wuhan,４３００５０,China．Departmentofgeneralsurgery,Hefengcountycentralhospital,Hefeng,４４５８０１AbstractobjectiveToexploretheeffectcontinuousrenalreplacementcombinedwithbloodperfusiononinflammatoryfactorsinpatientswithsevereacutepancreatitis．Methods６０patientswithacuteseverepancreatitisinourhospitalfromSeptember２０１１toOctober２０１４weredividedintoobservationgroupandconＧtrolgroup,３０casesineachgroup．Thecontrolgroupweretreatedwithcontinuousrenalreplacementtherapy(CRRT),andtheobservationgroupweretreatedwithCRRTcombinedwithbloodperfusion．Observedthechangesofinflammatorycytokinesandacutephysiologyandchronichealth(APACHE－II)scoresoftwogroupsbeforeandaftertreatment．ResultsTherewasnosignificantdifferenceinAPACHE－IIscoresbetweenthetwogroupsbeforetreatment(P＝０．５０１)．Thescoresoftheobservationgroupweresignificantlyhigherthanthoseofthecontrolgroup(Pbothwereequalto０．０００)aftertreatment５daysand１０days．TherewerenosignificantdifferencesinIL－６,IL－８andTNF－αlevelsinthetwogroupsbeforetreatment(P＞０．０５)．ButaftertreamentthelevelsofinflamＧmatoryfactorsintheobservationgroupweresignificantlylowerthanthoseinthecontrolgroup(Pallwereequalto０．０００)．ConclusionContinuousrenalreplaceＧmentcombinedwithbloodperfusioncansignificantlyimprovetheAPACHE－IIscoreinpatientswithsevereacutepancreatitis,andreducethelevelofinflammaＧtoryfaKcetoyrswo,rwdhsichhassiginificantclinicalefficacy．Continuousrenalreplacement;Bloodperfusion;Severeacutepancreatitis;Inflammatoryfactors中图分类号R５７６．１文献标识码B文章编号１００８－６３１５(２０１５)１２－１３５７－０２
出版日期
2015年12月22日（中国期刊网平台首次上网日期，不代表论文的发表时间）
