【摘要】 目的探讨连续性肾脏替代疗法(CRRT)对重症胰腺炎患者的治疗效果及其对肝肾功能的保护作用。方法选择2013年3月—2015年6月收治的重症胰腺炎74例,根据治疗方案分为观察组和对照组,每组37例。对照组采取常规治疗,观察组在对照组基础上加以CRRT治疗。比较2组临床疗效、并发症发生率、治疗前后急性生理与慢性健康评分(APACHEⅡ评分)、炎性介质指标及肝肾功能。结果 2组病死率、治疗3 d后肝功能指标比较差异无统计学意义(P>0.05)。观察组并发症发生率低于对照组(P<0.01)。治疗3 d后观察组APACHEⅡ评分、白介素(IL)-6、肿瘤坏死因子(TNF)-α、尿素(BUN)、肌酐(SCr)水平低于对照组,脂联素(APN)水平、24 h尿量高于对照组(P<0.05)。结论 CRRT能明显减轻重症胰腺炎患者肾脏功能损害程度,降低肾损害等并发症发生率,其作用机制可能是CRRT能显著清除炎性介质,减轻炎性反应。更多还原

【Abstract】 Objective To investigate therapeutic effect of continuous renal replacement therapy(CRRT) and its protective effect on hepatic and renal function on patients with severe pancreatitis( SP). Methods A total of 74 SP patients admitted during May 2013 and June 2015 were divided into observation group and control group( n = 37 for each group) according to different treatment methods. Control group was treated with routine therapy,while observation group was treated with CRRT on the basis of treatment for control group. Curative effects,incidence rate of complications,acute physiology and chronic health evaluation II( APACHE II) scores before and after treatment,indexes of inflammatory mediators and hepatic and renal function indexes were compared between the two groups. Results There were no significant differences in mortality rate and liver function indexes 3d after treatment between the two groups( P > 0. 05). Compared with those in control group,in observation group,incidence rate of complications was significantly lower( P < 0. 01); 3days after treatment,values of APACHE II scores,interleukin-6( IL-6),tumor necrosis factor-α( TNF-α),urea and serum creatinine( SCr) levels were lower,while values of adiponectin level and 24 h urine volume were significantly higher.Conclusion CRRT can significantly decrease the degree of renal function damage and significantly reduce incidence rate of complications such as renal damage in SP patients. Its mechanism may be that CRRT can significantly remove inflammatory mediators and reduce inflammatory reactions.更多还原