目的：探讨腹腔灌洗术联合高容量血液滤过治疗重症急性胰腺炎的临床效果。方法将72例重症胰腺炎患者随机分为研究组和对照组，每组36例。对照组患者给予单纯高容量血液过滤治疗，研究组在此基础上给予腹腔灌洗术联合高容量血液滤过治疗。对比两组患者生命体征变化、APACHE II 评分变化、治疗前后炎症因子水平和免疫细胞亚群变化。结果与对照组比较，研究组患者治疗后心率和体温显著降低（ P ﹤0.05）、呼吸频率无统计学差异（ P﹥0.05）。研究组患者治疗后各时点 APACHE II 评分显著低于对照组（ P ﹤0.01）。研究组患者治疗后各细胞因子水平显著低于对照组（ P ﹤0.05或 P ﹤0.01）。研究组患者 CD4+和 CD4+/ CD8+水平显著高于对照组（ P ﹤0.01或 P ﹤0.05）。结论腹腔灌洗术联合高容量血液滤过治疗重症急性胰腺炎可以有效改善患者的炎症状态并提高免疫水平，进而改善患者临床症状。%Objective To explore the clinical effect of peritoneal lavage combined with high volume hemofiltration in treatment of severe acute pancreatitis. Methods 72 cases of severe acute pancreatitis patients were randomly divided into study group and control group,36 cases in each group. The control group were only given the high capacity of blood filtration treatment,the study group was treated on the basis of peritoneal lavage combined with high volume hemofiltration therapy. The change of vital signs,APACHE II score changes before and after treatment,the lev-el of inflammatory factors and immune cell subsets change were compared. Results The study group patients after treatment significantly reduced the heart rate and body temperature( P ﹤ 0. 05),no significant difference in respiratory rate was found( P ﹥ 0. 05). Patients in study group at each time point APACHE II score was significantly lower than that of the control group( P ﹤ 0. 01). The levels of cytokines in patients of the study group after treatment were significantly lower than that of the control group( P ﹤ 0. 05,P ﹤ 0. 01). The study group of patients with CD4 +and CD4 + / CD8 + levels were significantly higher than those in the control group( P ﹤ 0. 01,P ﹤ 0. 05). Conclusion Peritoneal lavage com-bined with high volume hemofiltration in treatment of severe acute pancreatitis can effectively improve the level of inflammation patients and improve the immune level and improvement of clinical symptoms.
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