摘要
目的探讨连续高容量血液滤过（CHVHF）联合腹腔镜下行腹腔灌洗（LPLD）引流治疗重症急性胰腺炎（SAP）的疗效。方法SAP患者在常规治疗基础上应用床旁连续高容量血液滤过后联合腹腔镜下行腹膜腔灌洗引流，并与同期常规方法治疗的患者进行比较，分析两组在临床疗效指标、检验指标、细胞因子指标等方面的差异。结果采用连续高容量血液滤过联合腹腔镜下行腹腔灌洗引流治疗组的患者，不仅能够早期有效地清除血浆中、腹腔内的胰酶、炎症介质、细胞因子和内毒素等有害物质，而且可以较快地使血尿淀粉酶、白细胞、肝肾功能等恢复正常，从而能更早地缓解腹痛症状、恢复肠功能，缩短住院时间，减少并发症，降低死亡率，与同期常规方法治疗组比较差异均有统计学意义（P〈0．05）。结论连续高容量血液滤过联合腹腔镜下腹腔灌洗引流能有效地控制SAP的病情，有望成为治疗SAP的一种有效方法。
Objective To investigate the curative effects in the treatment of severe acute pancreatitis（SAP） with continuous high volume hemofihration combined with laparoscopic peritoneal lavage and drainage. Methods The clinical data of SAP treated at the early stage with continuous high volume hemofiltration combined with laparoscopic peritoneal lavage and drainage based on the conservative treatment in our hospital were compared with patients treated with conservative treatment. The clinical treatment effects, test results and cytokine were retrospectively analyzed. Results In the group of SAP with continuous high volume hemofiltration combined with laparoscopie peritoneal lavage and drainage, the hazardous substances were removed at the early stage and test results came back to the normal level quickly. Thus, the treatment can not only significantly relieve the abdominal pain, shorten the duration of intestinal function recovery and hospitalization, but also reduce the complications and mortality of SAP. Compared with the group received routine treatment （control group）, there was significant statistical difference （ all P 〈 0. 05 ）. Conclusion Continuous high volume hemofiltration combined with laparoscopic peritoneal lavage and drainage is feasible and safe for the treatment of SAP, and is recommended to use in clinical practice.
出处
《中国急救医学》
CAS
CSCD
北大核心
2010年第3期249-252,共4页
Chinese Journal of Critical Care Medicine
关键词
血液净化
连续高容量血液滤过
腹腔镜
腹腔灌洗
重症急性胰腺炎
Blood purification
Continuous high volume hemofiltration
Laparoscope
Peritoneal lavage
Severe acute pancreatitis
