發(fā)布時(shí)間：2018-02-14 12:42

  本文關(guān)鍵詞： 配對(duì)血漿分離吸附法 連續(xù)性血液凈化 重癥急性胰腺炎　出處：《中山大學(xué)學(xué)報(bào)(醫(yī)學(xué)科學(xué)版)》2015年06期 　論文類(lèi)型：期刊論文

【摘要】：【目的】觀(guān)察配對(duì)血漿分離吸附法(CPFA)對(duì)重癥急性胰腺炎(SAP)患者病情發(fā)展的影響、臨床療效和安全性,并探討其治療機(jī)制�！痉椒ā繉�30例重癥急性胰腺炎(SAP)患者隨機(jī)分為兩組,治療組15例采用CPFA技術(shù)治療,對(duì)照組15例采用常規(guī)連續(xù)性靜脈-靜脈血液濾過(guò)(CVVH)治療,所有患者均在ICU監(jiān)護(hù)中,30例患者比較治療過(guò)程的平均動(dòng)脈壓、Pa O2/Fi O2、TNF-α、IL-1β、IL-6、IL-10、肝腎功能生化指標(biāo)、血、尿淀粉酶、臨床改善程度以及APACHEⅡ評(píng)分的改善,同時(shí)觀(guān)察治療的副作用,同時(shí)隨訪(fǎng)病人的預(yù)后,統(tǒng)計(jì)分析其存活率。【結(jié)果】?jī)山M間治療前病情的嚴(yán)重程度基本無(wú)差異(P0.05),CPFA治療組患者在治療平均動(dòng)脈壓、Pa O2/Fi O2明顯上升(P0.05),促炎癥因子TNF-α、IL-1β、IL-6等因子明顯降低(P0.05),抗炎癥因子IL-10增加(P0.05),與對(duì)照組相比均有統(tǒng)計(jì)學(xué)差異(P0.05),治療組治療后APACHEⅡ評(píng)分呈下降趨勢(shì),至第10天明顯低于治療前和對(duì)照組(P0.05),治療組未發(fā)生休克、出血、過(guò)敏等嚴(yán)重并發(fā)癥,耐受好,并發(fā)癥的發(fā)生率無(wú)統(tǒng)計(jì)學(xué)差異(與對(duì)照組相比);治療組存活率12/15(80%)明顯高于對(duì)照組7/15(46.7%;P0.05)。【結(jié)論】CPFA可有效調(diào)整機(jī)體的免疫功能,改善重癥急性胰腺炎患者的預(yù)后,提高存活率,而且無(wú)明顯不良反應(yīng),值得在臨床上推廣。
[Abstract]:[objective] to observe the effect, clinical efficacy and safety of paired plasma separation and adsorption (CPFAA) on the development of severe acute pancreatitis (SAP) patients, and to explore its therapeutic mechanism. [methods] Thirty patients with severe acute pancreatitis (SAP) were randomly divided into two groups. 15 patients in the treatment group were treated with CPFA technique, and 15 patients in the control group were treated with routine continuous veno-venous hemofiltration (CVVH). 30 patients in ICU monitoring were compared with the mean arterial pressure Pa O 2 / fi O 2, TNF- 偽 IL-1 尾 and IL-6 IL-10, and the biochemical indexes of liver and kidney function. Blood, urine amylase, clinical improvement and APACHE 鈪，

本文編號(hào)：1510730