The clinical study of continuous veno-venous hemofiltration in treatment of severe acute pancreatitis

LIU Qiong; et al

doi:10.13406/j.cnki.cyxb.2005.05.027

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The clinical study of continuous veno-venous hemofiltration in treatment of severe acute pancreatitis

更新时间：2024-01-17

- The clinical study of continuous veno-venous hemofiltration in treatment of severe acute pancreatitis
- Journal of Chongqing Medical University Issue 5, (2005)
- 作者机构：
  
  1. 重庆医科大学附属第一医院急诊科
  2. 重庆医科大学附属第一医院急诊科,重庆,400016
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.2005.05.027
  CLC： R576
- Published：2005，
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[1]刘琼,黄纪坚,周发春.CVVH治疗重症急性胰腺炎的临床研究[J].重庆医科大学学报,2005(05):96-98+107.

LIU Qiong, et al. The clinical study of continuous veno-venous hemofiltration in treatment of severe acute pancreatitis. [J]. Journal of Chongqing Medical University (5).(2005)
[1]刘琼,黄纪坚,周发春.CVVH治疗重症急性胰腺炎的临床研究[J].重庆医科大学学报,2005(05):96-98+107. DOI： 10.13406/j.cnki.cyxb.2005.05.027.

LIU Qiong, et al. The clinical study of continuous veno-venous hemofiltration in treatment of severe acute pancreatitis. [J]. Journal of Chongqing Medical University (5).(2005) DOI： 10.13406/j.cnki.cyxb.2005.05.027.

摘要

目的:探讨连续性静脉-静脉血液滤过（CVVH）治疗重症急性胰腺炎（SAP）的疗效和机制。方法:21例SAP患者中心静脉置管建立血管通路

使用AV600聚砜膜滤器

发病后2.8±1.4天行CVVH治疗

CVVH平均持续44.6±30.7h。比较CVVH前后患者临床症状、体征、生化指标、细胞因子的变化。结果:CVVH治疗过程中患者血流动力学状态稳定

ICU存活率76.2%。与CVVH前比较

CVVH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（PaO2/FiO2）明显提高（P均<0.05）。血BUN、Cr、AST、ALT、AMY、LPS均明显下降（P均<0.05）。CVVH结束时细胞因子TNF-αI、L-6、γ-INF均明显下降

与治疗前比较差异十分显著（P<0.01）。结论:应用CVVH治疗SAP疗效肯定

CVVH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。CVVH的这些重要治疗作用可能与外周血中TNF-α、IL-6、γ-INF等炎症介质的有效清除有关。

Abstract

Objective:To explore the efficacy and mechanism of continuous veno-venous hemofiltration in treatment of severe acute pancreatitis(SAP).Methods:21 consecutive patients with SAP were included in this study.They were administrated with central venous catheteration.AV600 hemofilter(1.4m~2) was applied for CVVH.CVVH was started 2.8±1.4 days after onset of disease and sustained for 44.6±30.7 hours.We monitored the changes of symptorm

physical sign

laboratory examination and cytokines during CVVH.Results:The hemodynamic state in all patients was stable during CVVH.The overall surviral rate in ICU reached to 76.2%.After implement of the CVVH treatment

abdominal pain and abdominal distension were considerably improved.Temperature

heart rate

breath rate decreased significantly

as well as serum concentrations of BUN

ALT

ALP

AMY

LPS declined.There was a considerable reduction in cytokines including TNF-α

IL-6

γ-INF at the end of CVVH treatment.Conclusion:CVVH is an effective therapeutic option in treatment of SAP.The early clearance of inflammatory mediators including TNF-α

IL-6

and γ-INF is thought to be an important mechanism for improving outcome.

关键词

重症急性胰腺炎连续性静脉-静脉血液滤过炎性介质

Keywords

severe acute pancreatitisContinuous veno-venous hemofiltrationInflammatory mediators

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重庆医科大学临床学院普外科

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