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目的 探讨早期血液滤过治疗重症急性胰腺炎的疗效。方法 60例重症急性胰腺炎病人随机分为血滤组(HF)和非血滤组(NHF),每组30例。观测两组间APACHEⅡ评分、CT积分、局部和全身表现及体液细菌培养。结果 HF组及NHF组第10天APACHEⅡ评分和胰腺CT积分分别为(4.7±1.6)及(7.5±2.1)和(5.2±0.9)及(7.3±1.2)(P<0.05);HF组及NHF组腹痛消失时间和腹胀缓解时间分别为(24.5±12.3)h及(64.0±34.6)h和(18.9±5.2)h及(48.4±26.0)h(P<0.05);HF组体液细菌培养阳性率(26.7％)显著低于NHF组(53.3％),平均住院时间显著缩短,HF组(21±4)d,NHF组(32±7)d(P<0.05)。结论 重症急性胰腺炎病人行早期血液滤过治疗能有效缓解临床症状,改善重症急性胰腺炎的预后。
Objective To investigate the efficacy of early hemofiltration in the treatment of severe acute pancreatitis. Methods Sixty patients with severe acute pancreatitis were randomly divided into two groups, 30 patients in each group. The APACHE II score, CT score, local and systemic manifestations, and bacterial culture of body fluids were observed. Results The APACHEⅡscore and pancreatic CT score of HF group and NHF group on day 10 were (4.7 ± 1.6) and (7.5 ± 2.1) and (5.2 ± 0.9) and (7.3 ± 1.2), respectively (P <0.05) (24.5 ± 12.3) h and (64.0 ± 34.6) h and (18.9 ± 5.2) h and (48.4 ± 26.0) h, respectively (P <0.05). The positive rate of bacterial culture in HF group (26.7%) were significantly lower than those in NHF group (53.3%). The average length of hospital stay was significantly shorter in HF group (21 ± 4) d and NHF group (32 ± 7) d (P <0.05). Conclusion Early hemofiltration treatment in patients with severe acute pancreatitis can effectively relieve clinical symptoms and improve the prognosis of severe acute pancreatitis.