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目的总结重症急性胰腺炎(SAP)患者每日连续血液净化(CBP)治疗时间的经验,提高对SAP患者的治疗效率。方法对文献公开发表的32篇论文原文中SAP患者583例应用CBP治疗每日时间分别为6～8h、12～16h、18～24h的资料与进行内科常规治疗的163例患者的资料对比进行回顾性分析。结果治疗7d后CBP组的A-PACHEⅡ评分以及住院天数、存活率和病死率均明显优于对照组,差异有显著性(P<0.05);同时CBP组88.67%患者的血生化指标明显改善,82.14%患者的内毒素水平明显下降,而对照组仅分别为45.42%和40.47%,两组比较,差异有显著性(P<0.05)。但CBP每天6～8h、12～16h、18～24h的APACHEⅡ评分、存活率和病死率两组相似,三者间比较,差异无显著性(P>0.05)。结论早期CBP治疗能明显改善患者的APACHEⅡ评分,缩短住院时间,提高救治率,但每天治疗6～8h与更长时间的治疗效果相似,而且CBP6～8h更能科学合理地安排其他药物治疗时间。
Objective To summarize the experience of daily continuous blood purification (CBP) in patients with severe acute pancreatitis (SAP) and to improve the treatment efficiency in SAP patients. Methods A retrospective review of the data of 583 patients with SAP who were treated with CBP for 6 ~ 8h, 12 ~ 16h, 18 ~ 24h and SAP routinely treated in 163 articles published in literatures was conducted Sexual analysis. Results The A-PACHEⅡ score, the days of hospitalization, the survival rate and the mortality of CBP group were significantly better than those of the control group after 7 days of treatment (P <0.05). At the same time, the blood biochemical parameters of 88.67% The level of endotoxin in 82.14% of patients was significantly lower than that in control group (45.42% and 40.47%, respectively). There was significant difference between the two groups (P <0.05). However, the APACHE II score of 6 ~ 8h, 12 ~ 16h and 18 ~ 24h of CBP was similar between the two groups. There was no significant difference between the three groups (P> 0.05). Conclusion Early CBP treatment can significantly improve the APACHE Ⅱ score, shorten the hospital stay and improve the treatment rate, but the daily treatment of 6 ~ 8h and longer duration of treatment similar, and CBP 6 ~ 8h more scientific and rational arrangements for other drug treatment time.