【摘要】 目的　研究应用连续性静脉 静脉血液滤过 (CVVH)治疗重症急性胰腺炎 (SAP)时 ,不同的置换量对病情改善的作用。方法　选取A、B两组各 5例SAP病人接受CVVH治疗。A组为标准剂量置换液组 ,B组为大剂量置换液组。比较两组CVVH后的APACHEⅡ评分 (S)的变化情况。结果　在CVVH后第 1、3、5、7、9、11天B组的S值均低于A组 (P <0 .0 5 ) ,在CVVH后笫 13、15天 ,两组S值差异无显著性。结论　大剂量置换液有助于SAP病情的早期改善 ,但持续 2周的大剂量置换液治疗与标准剂量置换液治疗相比 ,在缓解病情方面可能并无优势更多还原

【Abstract】 Objective To find out whether different volumes of substitute fluid had different effects on the alleviation of severe acute pancreatitis (SAP) patients who underwent continuous veno venous hemofiltration (CVVH). Methods 10 SAP patients were divided into 2 groups,group A and group B (5 patients each), by the different volume of substitute fluid used.Group A had standard dosage volume of substitute fluid, while group B had larger volume.There were no differences in the two groups at age ,sex ,APACHEⅡ prior to CVVH. The APACHEⅡ(S) scores after CVVH were compared among the 2 groups.Results Group B had lower score than Group A 1,3,5,7,9,11 days after CVVH ( P <0.05).The S values in group B vs those in group A were:22.2±0.8 vs 24.4±1.1, P =0.01; 22.2±0.8 vs 23.6±0.9, P =0.034; 21.6±1.1 vs 24.0±1.0, P =0.008; 20.4±0.8 vs 22.0±0.7, P =0.015;20.0±0.7 vs 22.4±0.5, P =0.000; 19.6±0.5 vs21.2±0.4, P =0.001,respectively.But the APACHEⅡscores were not different between the two groups 13,15 days after CVVH .In comparison, group B vs groups A were:20.2±0.8 vs 20.0±0.7, P =0.694;20.0±0.7 vs 20.4±0.9, P =0.457; respectively.Conclusion Large dosage volume of substitute fluid in CVVH shows improvement of SAP earlier than standard dosage volume, but no benefit was seen when used for over two weeks.更多还原