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目的:探讨间断性血液透析滤过(IHDF)治疗重症急性胰腺炎(SAP)的疗效。方法:比较28例SAP患者IHDF前后临床症状、体征、生化指标的变化。结果:IHDF治疗过程中患者血流动力学状态稳定,ICU存活率82.7%,IHDF治疗后腹痛腹胀症状明显减轻,体温、心率、呼吸次数明显降低,动脉血氧分压(PaO2)和氧合指数(Pa02/FiO2)明显提高。血BUN、Cr、AST、ALT、AMY、LPS均明显下降。结论:应用IHDF治疗SAP疗效肯定,IHDF不仅能迅速减轻SAP患者的局部症状和体征,而且更重要的是能阻断全身炎症反应,改善氧合和组织氧代谢,缩短病程,改善预后。
Objective: To investigate the efficacy of intermittent hemodiafiltration (IHDF) in the treatment of severe acute pancreatitis (SAP). Methods: The changes of clinical symptoms, signs and biochemical indexes in 28 SAP patients before and after IHDF were compared. Results: The hemodynamic status of patients with IHDF was stable during the course of IHDF. The ICU survival rate was 82.7%. The symptoms of abdominal pain and abdominal distension were significantly reduced after IHDF treatment. The body temperature, heart rate and respiratory rate were significantly decreased. PaO2 and oxygenation index (Pa02 / FiO2) significantly improved. Blood BUN, Cr, AST, ALT, AMY, LPS were significantly decreased. CONCLUSIONS: IHDF is effective in treating SAP. IHDF not only can relieve the local symptoms and signs of SAP patients rapidly, but more importantly, it can block systemic inflammatory response, improve oxygenation and tissue oxygen metabolism, shorten the course of disease and improve prognosis.