目的：观察连续性血液净化(CBP)治疗重症急性胰腺炎(SAP)的效果，探讨提高SAP临床疗效的治疗措施。方法2009年1月-2012年12月期间在该院重症医学科收治的30例SAP患者随机均分为两组。观察两组患者生命体征、腹部体征，监测血液生化指标、炎症指标、氧合指数、APACHEⅡ、CT严重度指数( CTSI)，分析两组病死率。结果CBP组患者的体温、呼吸、心率、氧合恢复正常值所占比率较常规组升高；CBP组腹痛消失时间，腹胀缓解时间均较常规组缩短；CBP组氧合指数、肝肾功能较常规组改善；CBP组降钙素原、C反应蛋白、白细胞、血淀粉酶、APACHEⅡ评分及CTSI较常规组降低。 CBP组抢救成功率93%，病死率6.7%；常规组抢救成功率80%，病死率20%。结论 CBP改善和维持患者重要脏器功能，能有效救治临床并发症，降低病死率，改善SAP的预后。%Objective To evaluate the efficacy of continuous blood purification in the treatment of severe acute pancreatitis and to ex-plore new methods for treatment of SAP. Methods Thirty SAP patients treated at Affiliated Anqing Hospital of Anhui Medical Univer-sity from January 2009 to December 2012 were randomly assigned into the conventional group(n=15) and the CBP group(n=15). Their viral signs,abdominal symptoms and signs were recorded. Blood biochemical parameters,inflammation markers,oxygenation in-dex,acute physiology and chronic health evaluation ( APACHEIIscore) and CT severity index were observed. The mortalities were an-alyzed . Results The APACHEII scores and CT severity index in the CBP group were significantly lower than those in the conventional group. The relief durations of abdominal pain and abdominal distension were significantly shortened in the CBP group. Compared with the conventional group, the serum amylase, white blood cell, C-reactive protein, procalcitonin were reduced significantly in the CBP group. Hepatic and renal function,oxygenation index were improved significantly in the CBP group. The success rate was 93% and the mortality was 6. 7% in the CBP group,while the success rate was 80% and the mortality was 20% in the conventional group. The mor-tality was significantly shortened in the CBP group. Conclusions CBP can improve and maintain the function of important organs in patients with SAP,significantly cut down mortality,treat clinical complications,and ameliorate the prognosis of SAP.
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