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目的:探讨区域动脉灌注(CRAI)联合血液净化治疗重症急性胰腺炎(SAP)的临床疗效。方法:将2008年1月—2011年1月采用CRAI联合血液净化治疗的23例(灌注组)SAP患者与2005年1月—2007年12月采用传统方法治疗的26例SAP患者(传统组)的临床资料进行历史对照分析,比较两组治疗前后各项临床指标的变化情况及治疗效果。结果:治疗前两组各项临床指标无统计学差异(均P>0.05),治疗后第3,7天灌注组体温、心率、APACHE-II评分、白细胞计数、谷丙转氨酶和肌酐水平与传统组比较明显降低,而氧合指数、血小板计数明显增加(P<0.05或P<0.01);灌注组腹痛、腹胀消失时间及肠功能恢复时间和住院时间均短于传统组(均P<0.01);灌注组并发症发生率、中转手术率、病死率均低于传统组(P<0.05或P<0.01)。结论:CRAI联合血液净化治疗能提高SAP治愈率、降低病死率,减少并发症,是治疗重症急性胰腺炎的有效方法。
Objective: To investigate the clinical efficacy of regional arterial infusion (CRAI) combined with blood purification in the treatment of severe acute pancreatitis (SAP). Methods: From January 2008 to January 2011, 23 cases of SAP patients treated with CRAI combined with blood purification and 26 cases of SAP patients treated with traditional method from January 2005 to December 2007 (traditional group) The clinical data of the historical control analysis, compared the two groups before and after treatment of clinical indicators of changes and treatment. Results: There was no significant difference between the two groups before treatment (all P> 0.05). The body temperature, heart rate, APACHE-II score, white blood cell count, alanine aminotransferase (P <0.05 or P <0.01). The abdominal pain, disappearance of abdominal distension, intestinal function recovery time and hospital stay in the perfusion group were shorter than those in the traditional group (all P <0.01) The incidence of complications, the rate of surgeries and the mortality in the perfusion group were lower than those in the traditional group (P <0.05 or P <0.01). Conclusion: CRAI combined with blood purification can improve the cure rate of SAP, reduce the mortality and reduce the complications, and it is an effective method for the treatment of severe acute pancreatitis.