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早期血液滤过对伴有腹腔间隔室综合征的重症急性胰腺炎患者器官功能及腹内压的影响

Effects of early hemofiltration on organ function and intra-abdominal pressure in severe acute pancreatitis patients with abdominal compartment syndrome
.

作者信息

Xu Jian-Min, Yang Huan-Dong, Tian Xiang-Ping

出版信息

Clin Nephrol. 2019 Nov;92(5):243-249. doi: 10.5414/CN109435.

DOI:10.5414/CN109435
PMID:31448719
Abstract

OBJECTIVE

To study the effects of early continuous veno-venous hemofiltration (CVVH) on organ function and intra-abdominal pressure (IAP) in severe acute pancreatitis (SAP) patients with abdominal compartment syndrome (ACS).

MATERIALS AND METHODS

48 SAP patients with ACS were included in this study. Among them, 37 patients, receiving both conventional treatment and hemofiltration therapy in the ICU, were regarded as the treatment group, and the rest, receiving only conventional treatment, were regarded as the control group. Symptoms, signs, and adverse reactions of both groups were observed and recorded during treatments. Serum and urine amylase, liver and kidney function, C-reactive protein, and intra-abdominal pressure of the patients were detected before and on days 1, 2, 3, 4, 5, and 6 after treatment.

RESULTS

  1. Symptoms and signs in the treatment group disappeared quickly, and their hospitalization time was significantly shorter than those of control group (p < 0.05). 2. After treatment, on days 1, 2, 3, 4, 5, and 6, patients' serum and urine amylase levels, C-reactive protein, and intra-abdominal pressure were significantly lower, and liver and kidney function was significantly better than those of the control group (p < 0.05).

CONCLUSION

Early hemofiltration in SAP with ACS can effectively reduce intra-abdominal pressure, improve symptoms, accelerate liver and renal function recovery, avoid multiple organ failure and decrease mortality rate.

摘要

目的

研究早期连续性静脉-静脉血液滤过(CVVH)对伴有腹腔间隔室综合征(ACS)的重症急性胰腺炎(SAP)患者器官功能及腹内压(IAP)的影响。

材料与方法

本研究纳入48例伴有ACS的SAP患者。其中,37例在重症监护病房接受常规治疗及血液滤过治疗的患者作为治疗组,其余仅接受常规治疗的患者作为对照组。治疗期间观察并记录两组患者的症状、体征及不良反应。检测患者治疗前及治疗后第1、2、3、4、5、6天的血清及尿淀粉酶、肝肾功能、C反应蛋白及腹内压。

结果

  1. 治疗组症状和体征消失快,住院时间显著短于对照组(p<0.05)。2. 治疗后第1、2、3、4、5、6天,患者血清及尿淀粉酶水平、C反应蛋白及腹内压显著低于对照组,肝肾功能显著优于对照组(p<0.05)。

结论

伴有ACS的SAP患者早期进行血液滤过可有效降低腹内压,改善症状,加速肝肾功能恢复,避免多器官功能衰竭并降低死亡率。

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Effects of early hemofiltration on organ function and intra-abdominal pressure in severe acute pancreatitis patients with abdominal compartment syndrome
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