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1、连续血液滤过对重症急性胰腺炎治疗作用作者：陈嘉屿，张方信，吴红梅，刘丽华，赵丽【关键词】血液滤过；急性病；胰腺炎Curativeeffectofcontinuousvenovenoushemofiltrationinpatientswithsevereacutepancreatitis[Abstract】AIM：Toobservethetreatmenteffectofcontinuousvenovenoushemofiltration(CVVH)inpatientswithsevereacut
2、epancreatitis(SAP)・METHODS：TwentysixSAPpatientswererandomlydividedinto2groups：CVVHgroup(A,n二11)andcontrolgroup(B,n二15).BothofgroupAandBweretreatedwithconventionaltherapy,whilethepatientsingroupAadditionallyunderwentCVVH.Heartrate(HR),respiration(R),b
3、loodpressure(BP),functionsofliver,kidneyandgastrointestinewereobserved.P02/Fi02,Sa02,plasmalevelsofelectrolyteandglucose,Creactiveprotein(CRP)andbloodroutineweredetermined.APACHEIIscoreswereusedtoevaluatethepatientsconditions.RESULTS:Whitebloodcell(W
4、BC),plasmalevelsofglucoseandcalciumwereimprovedingroupAandB24haftertreatment(P&It；0.05).GroupAwasbetterthangroupBintermsofthefunctionsofliver,kidneyandAPACHEIIscores(P<；0.05).Sevendayslater,CRPwasdecreasedinbothAandB(P&It；0.05),butmoredistinctlying
5、roupA(P<；0.05).Bwasalsoimprovedinthefunctionsofliver,kidneyandAPACHEIIscores(P&It；0・05).Theincidencesofacutelunginjuryandcomplicationswerereducedsignificantlyinthe2groups(P&It；0.05).Thehydrocelewasremovedrapidlyinbothchestandabdomenandtheincidenceo
6、fcomplicationswasdecreased(P<；0.05).CONCLUSION：CVVHmaycorrecttheliverandrenaldysfunctionsthatwerebroughtoutbySAP,improvephysicalconditions,andpreventefficientlythecomplications・[Keywords]hemofiltration；acutedisease；pancreatitis【摘要】目的：观察连续血液滤过对重症急性胰
7、腺炎的治疗作用.方法：26例重症急性胰腺炎患者分为2组:连续血液滤过组(A组，n=ll)和对照组(B组，n=15).在用常规治疗的基础上，A组加用连续血液滤过.观察两组患者的心率、呼吸、血压、肝、肾功能及胃肠功能指标；氧合指数(PO2/FiO2)、血氧饱和度(Sa02)；血浆电解质、葡萄糖、血常规以及C反应蛋白；并行APACHEII评分.结果：治疗后24h,A,B两组白细胞、血糖、血钙水平均明显好转(P<；O.05),A组肝肾功能指标、APACHEII积分与B组比较显著改善(P<；0.0
8、5)；7d后观察，两组C反应蛋白均下降(P<；0.05),A组下降更明显(P<；0.05),B组肝肾功能及APACHEII积分亦显著好转(P<；0.05)；两组治疗后急性肺损伤、并发症总发生率均明显下降(P<；0.05),组间比较，A组胸腹腔积液消除迅速、并发症总发生率下降(P<；0.05).结论：连续血液滤过可早期纠正重症急性胰腺炎引起的肝肾功能障碍，改善全身状况，并能有效防止并发症的发生.【关键词】血液滤过；急性病；胰腺炎0引言重症急性胰腺炎(severeacutepan
