摘要
目的观察连续性血液净化（CBP）的高容量血液滤过（HVHF）和常规剂量的连续性静脉-静脉血液滤过（CVVH）治疗重症急性胰腺炎（SAP）患者的效果。方法43例SAP患者随机分为HVHF组和CVVH组，分别检测两组患者治疗前、治疗后每24h血清C反应蛋白（CRP）水平，比较两组预后、治疗前后APACHEⅡ评分变化及血清CRP水平在各个时间点有无显著性差异。结果HVHF组22例患者死亡3例，死亡率13．64％；CVVH组21例患者死亡8例，死亡率38．10％。两组治疗后APACHEⅡ评分均较治疗前差异有统计学意义（P〈0．05），但以HVHF组更为显著（P〈0．05）。两组均能降低血清CRP水平，但以HVHF组下降更为明显（P〈0．01），HVHF组各时间点CIIP水平均较CVVH组显著降低，两组比较差异有统计学意义（P〈0．05）；在HVHF治疗期间，血清CRP水平逐渐降低，以治疗后72h下降更为明显，与治疗前、治疗后24h、48h比较，差异均有统计学意义（P〈0．01）。结论在SAP患者连续性血液净化治疗方式选择上，更适宜选用HVHF治疗；连续的CRP检测有助于判断SAP患者HVHF治疗的预后。
Objective To investigate the therapeutic effects of continuous high - volume hemofiltration（ HVHF ） and continuous veno -venous hemofihration （CVVH） in severe acute pancreatitis （SAP）. Methods Forty - three patients were randomly divided into 2 groups ： HVHF group and CVVH group. The C - reactive protein （CRP） levels before treatment and every 24 hours after treatment were measured respectively in the 2 groups, the prognosis, the pre - and post - treatment APACHE I score and the CRP level at different time points were compared. Results Three patients died in HVHF group which contained twenty -two patients, the mortality rate was 13.64 percent; eight patients died in CVVH group which contained twenty -one patients, the mortality rate was 38. 10 percent. There was significantly different in APACHE II score between pre - and post - treatment （ P 〈 0. 05 ）, especially in HVHF group（ P 〈 0.05 ）. Serum CRP were decreased more significantly at different time points in HVHF than in CVVH group （ P 〈 0. 05 ）, and CRP were decreased more significantly at 72 b than pretreatment and at 24 h,48 h in HVHF group （P 〈 0. 01 ）. Condusion HVHF is more beneficial for SAP patients than other continuous blood purification （CBP） methods. Continuous CRP detection can help to judge the prognosis with HVHF in SAP.
出处
《中国急救医学》
CAS
CSCD
北大核心
2011年第6期534-536,共3页
Chinese Journal of Critical Care Medicine
