目的:比较脉冲式高容量血液滤过(PHVHF)与连续性血液滤过(CVVH)治疗重症急性胰腺炎(SAP)的疗效.方法:38例SAP患者随机接受PHVHF或CVVH治疗,分别为18例及20例,血滤72 h后观察两组治疗前后临床症状,急性生理学及慢性健康状况评价Ⅱ(APACHE Ⅱ)评分,生化指标的改变及病死率.结果:治疗后两组症状明显改善.APACHEⅡ评分、血清淀粉酶、肝功能、血肌酐、白细胞和CRP均有下降(P<0.05).低氧血症,酸中毒纠正,PHVHF组优于CVVH组,在心率、呼吸、肝功能、APACHEⅡ评分方面差异显著(P<0.05).PHVHF组病死率为11.1%,CVVH组为25%.结论:PHVHF治疗SAP效果显著,明显优于CVVH组,可以作为SAP的重要辅助治疗.%Objective To investigate the effects of pulse high-volume hemofiltration (PHVHF)and continuous veno-venous hemofiltration (CVVH) on the severe acute pancreatitis(SAP). Methods Thirty-eight SAP patients were randomly divided into two groups :the PHVHF group (n= 18) and the CVVH group (n= 20). After 72-hour hemofiltration, the following tests were performed, including clinical symptoms, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score, biochemical changes, as well as the mortality. Results Symptoms of both of the two groups were markedly improved after receiving corresponding treatments. APACHE Ⅱ score, serum amylase,liver function, creatinine,white blood cells and CRP level were decreased significantly (P ＜ 0.05). However,hypoxemia and acidosis recoveryies in PHVHF group were better than those in CVVH group, especially, significant differences at the heart rate,breathing, liver function and APACHE Ⅱ score were found between two groups (P ＜0.05). The mortality was 11.1 ％ and 25％ in PHVHF group and CVVH group, respectively. Conclusion PHVHF is obviously more better than CVVH in the treatment of SAP, and PHVHF can be served as an important adjuvant therapy for SAP.
展开▼
