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目的:观察早期间断短时血滤(ISVVH)治疗重症急性胰腺炎(SAP)的临床疗效并探讨其机制。方法:50例SAP患者随机分为血滤组(HF组)30例进行ISVVH治疗,非血滤组(NHF组)20例未接受ISVVH治疗。对比观察两组患者的腹痛消失、腹胀缓解时间、APACHEⅡ评分以及促炎细胞因子(TNF-α、IL-1β、IL-6、IL-8)的变化。结果:治疗前,两组患者的APACHEⅡ评分无显著差异(P>0.05)。治疗后,HF组患者的腹痛消失、腹胀缓解时问明显缩短(P<0.05),APACHEⅡ评分显著降低(P<0.05),促炎细胞因子较入院时和NHF组有显著降低(P<0.05)。结论:SAP早期行ISVVH治疗可清除体内过多的促炎细胞因子,有利于控制病情,提高疗效。
Objective: To observe the clinical efficacy of early intermittent short-term hemofiltration (ISVVH) in the treatment of severe acute pancreatitis (SAP) and to explore its mechanism. Methods: Fifty patients with SAP were randomly divided into three groups: 30 patients in the HF group received ISVVH treatment, and 20 patients who did not receive ISVVH in the non-blood group (NHF group). Abdominal pain disappeared, abdominal distension time, APACHEⅡscore and the changes of proinflammatory cytokines (TNF-α, IL-1β, IL-6 and IL-8) were compared between the two groups. Results: There was no significant difference in APACHEⅡ scores between the two groups before treatment (P> 0.05). After treatment, the abdominal pain disappeared, the bloating relieved significantly shortened (P <0.05), the APACHEⅡscore decreased significantly (P <0.05), the proinflammatory cytokines were significantly lower than those on the admission and the NHF group (P <0.05) . Conclusion: The early treatment of SAP with ISVVH can clear excessive proinflammatory cytokines in vivo, which is beneficial to control the disease and improve the curative effect.