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目的分析配对血浆滤过吸附(CPFA)联合高容量血液滤过(HVHF)治疗重症急性胰腺炎临床效果,并对其实用性和安全性进行探讨。方法对我院32例重症急性胰腺炎患者临床资料进行回顾性分析,随机将患者分为治疗组(16例)和对照组(16例)。两组实施常规治疗方法,治疗组在常规治疗基础上,采用配对血浆滤过吸附联合高容量血液滤过方法(CPFA+HVHF)。对照组采用高容量血液滤过方法(HVHF)治疗。对比治疗前、后两组患者APACHEⅡ评分、血脂、肝肾功能、白细胞以及临床症状改善程度(包括呼吸、心率、氧合指数等),并对患者脏器功能进行评估,观察患者治疗期间不良反应和预后情况。结果经过不同治疗方法后,两组患者生命体征各项指标均有明显改善,其中治疗组指标改善情况更加明显。治疗组三酰甘油下降明显(P<0.05),且治疗组血液净化时间和住院时间少于对照组(P<0.05);两组患者均未出现血小板减少、过敏、出血、凝血等不良反应。结论 CPFA与HVHF联合用于治疗重症急性胰腺炎,能够有效控制炎症,降低患者血脂,改善患者预后。
Objective To analyze the clinical effect of paired plasma filtration adsorption (CPFA) combined with high volume hemofiltration (HVHF) in the treatment of severe acute pancreatitis and to discuss its practicability and safety. Methods The clinical data of 32 patients with severe acute pancreatitis in our hospital were retrospectively analyzed. The patients were randomly divided into treatment group (16 cases) and control group (16 cases). The two groups were treated by conventional therapy. The treatment group was treated with paired plasma filtration and high volume hemofiltration (CPFA + HVHF) on the basis of routine treatment. The control group was treated with high volume hemofiltration (HVHF). APACHEⅡscore, blood lipid, liver and kidney function, white blood cells and the improvement of clinical symptoms (including respiration, heart rate and oxygenation index) were compared between the two groups before and after treatment. The patients’ organ function was evaluated. The adverse reactions And prognosis. Results After different treatment methods, the two groups of patients with vital signs significantly improved the indicators, including the treatment group indicators to improve the situation even more pronounced. Triacylglycerol in the treatment group decreased significantly (P <0.05), and the blood purification time and hospitalization time in the treatment group were less than those in the control group (P <0.05). No adverse reactions such as thrombocytopenia, allergy, hemorrhage and coagulation occurred in both groups. Conclusion Combined use of CPFA and HVHF in the treatment of severe acute pancreatitis can effectively control the inflammation, reduce the blood lipid and improve the prognosis of patients.