连续性肾脏替代治疗术对重症急性胰腺炎生化及生理指标的影响

摘要

目的 探讨连续性肾脏替代治疗术(CRRT)对重症急性胰腺炎(SAP)生化及生理指标的影响.方法 随机选取住院治疗的SAP患者98例,分为试验组(n=49)和对照组(n=49),试验组接受CRRT治疗,对照组常规治疗.检测并比较2组患者治疗前后的临床症状、肝肾功能及动脉血气分析等指标.结果 试验组患者在治疗后12h内呼吸、心率、氧分压(PO2)、二氧化碳分压(PCO2)、碱剩余(BE)、pH明显改善,持续到治疗后36 h,各项指标与对照组比较,差异均有统计学意义(P＜0.05).试验组患者在治疗后12 h内血钙上升,肌酐、尿素氮、血糖水平下降明显,血钾、血钠水平稳定,与对照组比较,差异均有统计学意义(P＜0.05).试验组患者在治疗36 h后丙氨酸氨基转移酶(ALT)下降明显,与治疗前差异有统计学意义(P＜0.05).试验组与对照组的红细胞比容(HTC)、白细胞计数(WBC)与治疗前差异有统计学意义(P＜0.05),试验组患者在12 h内血小板计数(PLT)下降,与治疗前差异有统计学意义(P＜0.05).结论 与常规治疗相比,CRRT治疗SAP疗效更加显著,患者生理、生化指标改善明显,对患者的预后意义重大.%Objective To investigate the effects of continuous renal replacement therapy (CRRT) on biochemical and physiological indexes of severe acute pancreatitis (SAP) and its clinical efficacy.Methods Totally 98 patients with severe acute pancreatitis admitted in our hospital were divided into experimental group(n=49) and control group(n=49).The experimental group received CRRT and the control group did not receive.Heart rate,body temperature,blood routine,urine output,mean arterial pressure,liver function,blood biochemistry and arterial blood gas analysis before and after treatment in the two groups were measured and compared before and after treatment.Results In the experimental group,respiration,heart rate,oxygen partial pressure (PO2),carbon dioxide partial pressure (PCO2),alkali residual (BE) and pH were significantly improved at 12 h after treatment,and lasted until 36 h after treatment;the differences were statistically significant (P＜0.05).In the experimental group,blood calcium increased,creatinine,urea nitrogen and blood sugar level decreased significantly,blood potassium and blood sodium level were stable within 12 h after treatment,and the difference was statistically significant,compared with the control group (P＜0.05).In the experimental group,the alanine aminotransferase (ALT) decreased significantly after 36 h of treatment,and the difference was statistically significant(P＜0.05).There was a significant difference between the experimental group and the control group in the hematocrit (HTC) and white blood cell count (WBC) before treatment (P＜ 0.05).The platelet count (PLT) in the experimental group decreased within 12 h,and the difference was statistically significant before treatment(P＜0.05).Conclusion Compared with the conventional treatment,the therapeutic effect of CRRT on SAP is more significant.The improvement of the physiological and biochemical indexes of the patients is obvious,which is of great significance to the prognosis of the patients.