天津医药

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配对血浆滤过吸附联合高容量血液滤过治疗重症急性胰腺炎的临床研究

王俊霞1,徐艳梅2   

  1. 1. 河南科技大学第一附属医院血液净化科
    2. 湖北省武汉市普爱医院
  • 收稿日期:2013-02-22 修回日期:2013-06-25 出版日期:2013-10-15 发布日期:2013-10-15
  • 通讯作者: 徐艳梅

Clinical Study of Coupled Plasma Filtration Adsorption Combined with High Volume Hemofiltration Treatment in Patients with Severe Acute Pancreatitis

WANG Jun xia1,xu yan mei2   

  1. 1. Department of Blood Purification, First Affiliated Hospital of Henan University of Science and Technology
    2. Hubei Province, Wuhan City, universal love hospital
  • Received:2013-02-22 Revised:2013-06-25 Published:2013-10-15 Online:2013-10-15
  • Contact: xu yan mei

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摘要：

【摘要】  目的  观察应用配对血浆滤过吸附（CPFA）联合高容量血液滤过（HVHF）治疗重症急性胰腺炎（SAP）的临床疗效，探讨其实用性、安全性及治疗机制。  方法  将29例SAP患者随机分为2组，采用前瞻性随机对照研究。在常规治疗基础上，治疗组（15例）采用CPFA+HVHF治疗，对照组（14例）采用HVHF治疗，所有患者均在重症监护中，比较治疗前后2组患者的APACHEⅡ评分，血脂，肝、肾功能，白细胞以及临床症状改善程度（心率、呼吸、平均动脉压、氧合指数等），评估脏器功能，观察不良反应及预后。  结果  2组患者治疗后生命体征均有明显改善，APACHEⅡ评分及白细胞下降明显，氧合指数上升，尤以治疗组效果更明显，且治疗7d时效果优于3d，治疗组三酰甘油下降明显（均P＜0.05）。患者无血小板减少、出血、过敏、凝血等不良反应发生，治疗组需血液净化治疗的时间及住院天数少于对照组（P＜0.05），但2组死亡情况无明显差异。  结论  CPFA联合HVHF能更有效地调控炎症，降低血脂，改善SAP患者预后。

关键词: 配对血浆滤过吸附, 高容量血液滤过, 急性重症胰腺炎

Abstract:

 [Abstract]   Objective   To observe the clinical efficacy of coupled plasma filtration adsorption (CPFA) combined
with high volume hemofiltration (HVHF) for severe acute pancreatitis (SAP) and explore the practicality, the safety and the therapeutic mechanism.  Methods  This was a prospective, randomized clinical trail. A total of29patients with SAP were divided into two groups: treatment group (n=15, CPFA and HVHF) and control group (n=14, HVHF). The APACHEⅡscore, serum triglyceride, liver and kidney function, white blood cell (WBC), heart rate (HR), respiration, mean arterial pressure (MAP) and oxygenation index were compared before and after treatment between two groups. The organ function was assessed, and the adverse reactions and prognosis were observed in two groups. Results   After treatment, there were significant decreases in APACHEⅡscore and WBC, and significant increase in PaO2/FiO2 in two groups, especially significant in treatment group. There was a significant decrease in the level of triglycerides in 7-d treatment group than that of3-d treatment group (P＜0.05). There were no thrombocytopenia, bleeding, allergies, blood clotting and other adverse reactions in two groups of patients. There were significant decreases in the blood purification time and the length of hospital stay in treatment group than those of control group (P＜0.05). There was no significant difference in mortality between two groups.   Conclusion   CPFA combined with HVHF can effectively control inflammation, reduce the serum level of triglyceride and improve the prognosis in patients with SAP.

Key words: Coupled plasma filtration adsorption, High volume hemofiltration, Severe acute pancreatitis