摘要
目的:观察联合应用血浆置换(PE)及连续静脉-静脉血液滤过(CVVH)治疗高脂血症性重症急性胰腺炎的疗效。方法:本研究回顾分析2010年1月至2014年1月在本院治疗的27例高脂血症性重症急性胰腺炎,随机分为血液滤过组(CVVH组)及血浆置换+血液滤过组(PE+CVVH组),比较分析两组患者的血脂、腹腔压力变化情况、需胸腹腔积液穿刺率、氧合指数、禁食时间、血淀粉酶恢复正常时间、机械通气时间、ICU滞留时间、住院时间及28 d存活率。结果:与CVVH组相比,PE+CVVH组于入ICU第2、3、5、7天血三酰甘油及胆固醇均明显降低(P<0.05),需胸腹腔积液穿刺率明显下降(P<0.05),第3、5、7天腹腔压力均明显降低(P<0.05),而氧合指数均明显增加(P<0.05),且血淀粉酶恢复正常时间、禁食时间、机械通气时间、ICU滞留时间及住院时间均明显缩短(P<0.05);两者28 d存活率差异无统计学意义(P>0.05)。结论:联合血浆置换及血液滤过治疗高脂血症性重症急性胰腺炎可早期清除高脂血症,减轻液体渗出,减少机械通气时间、ICU滞留时间及住院时间,不影响28 d存活率。
Objective To investigate the effect of plasma exchange（ PE） combined continuous veno-venous hemofiltration（ CVVH） on the patients with hyperlipidemic severe acute pancreatitis. Methods From January 2010 to January 2014,27 patients with hyperlipidemic severe acute pancreatitis in our hospital were randomly divided into CVVH group and PE combined CVVH group. The blood lipids level,intra-abdominal pressure,ratio of splanchnocoel paracentesis,oxygenation index,fasting time,time of blood amylase returned to normal,mechanical ventilation time,ICU resident time,hospitalization time and rate of 28 days survival of the two groups were recorded and comparatively analyzed. Results Compared with CVVH group,the blood triglyceride and cholesterol of patients in PE combined CVVH group were obviously decreased at the second,third,fifth,seventh day after enter ICU（ P 0. 05）,and the ratio of puncture rate of pleural effusion and the intra-abdominal pressure were also significantly decreased（ P 0. 05）,while the oxygenation index was significantly increased（ P 0. 05）,and the time of serum amylase returned to normal,fasting time,mechanical ventilation time,ICU resident time and hospitalization time were significantly shorter（ P 0. 05）. The rate of 28 days survival had no significant difference（ P 0. 05） between the two groups. Conclusion PE combined CVVH could early release hyperlipidemia,decrease fluid leakage,shorten duration of mechanical ventilation,reduce ICU and hospitalization resident time of patients with hyperlipidemic severe acute pancreatitis,but has no effect on the rate of 28 days survival.
出处
《湖北医药学院学报》
CAS
2015年第3期254-257,共4页
Journal of Hubei University of Medicine
关键词
高脂血症
重症急性胰腺炎
血浆置换
血液滤过
Hyperlipidemia
Severe acute pancreatitis
Plasma exchange
Hemofiltration
