黄美英，王　洁，黄　鹏，古贤君，黄非凡，王统华

1.右江民族医学院附属医院肾内科，广西百色　533000；

2.右江民族医学院附属医院消化内科，广西百色　533000

血液灌流联合CRRT治疗重症急性胰腺炎合并急性肾损伤的临床疗效分析

黄美英1，王洁1，黄鹏1，古贤君1，黄非凡1，王统华2

1.右江民族医学院附属医院肾内科，广西百色533000；

2.右江民族医学院附属医院消化内科，广西百色533000

目的探讨血液灌流联合CRRT临床治疗重症急性胰腺炎合并急性肾损伤的效果。方法 方便选取并回顾分析右江民族医学院附属医院2012年1月—2015年1月收治的66例急性胰腺炎合并肾功能损伤患者的临床治疗资料。所有患者均接受常规胰腺炎治疗，按照治疗方式分组，其中39例患者（对照组）进行血液滤过治疗，其余27例患者（观察组）采取血液灌流联合CRRT治疗。比较患者的临床症状、体征、生化指标的变化。结果观察组患者血肌酐值、血淀粉酶值、总胆固醇等指标在治疗之后均出现明显下降（P＜0.05）。以第3天为例，观察组的总胆固醇为（4.46±2.24）mmol/L，对照组为（5.94±1.53）mmol/L；观察组甘油三酯（2.27±1.55）mmol/L，对照组是（3.02±1.59）mmol/L。临床效果优于对照组差异有统计学意义（P＜0.05）。结论 采用血液灌流联合CRRT治疗重症急性胰腺炎合并急性肾损伤，可以有效地遏止患者病情的恶化，增加康复机率，提升治疗效果，具有很强的临床应用价值。

血液灌流；CRRT；重症急性胰腺炎；急性肾损伤

［Abstract］Objective To investigate the clinical effect of combined therapy of blood perfusion combined with CRRT in the treatment of severe acute pancreatitis complicated with acute renal injury.Methods Group selection the clinical data of 66 cases of acute pancreatitis complicated with renal injury treated in the Affiliated Hospital of Youjiang Medical College For Nationalities during January 2012 to January 2015 were retrospective analized.All patients were treated with conventional pancreatitis，grouping according to treatment，of which 39 patients（control group）were treated with blood filtration，and the other 27 patients（observation group）were treated with CRRT.The changes of clinical symptoms，signs and biochemical indexes of the patients were compared.Results Observation group of patients with serum creatinine，blood amylase，total cholesterol and other indicators after the treatment were significantly decreased（P＜0.05），Take third days as an example，the total cholesterol of the observation group was（4.46±2.24）mmol/L，the control group was（5.94±1.53）mmol/L；the observation group triglyceride（2.27±1.55）mmol/L，the control group was（3.02±1.59）mmol/L.The clinical effect is better than the control group.the difference was statistically significan（P＜0.05）.Conclusion With blood perfusion combined with CRRT in the treatment of severe acute pancreatitis combined with acute renal failure，can effectively curb the deterioration of the patient's condition and increase the chances for recovery and improve the treatment effect，has a strong value in clinical application.

［Key words］Blood perfusion；CRRT；Severe acute pancreatitis；Acute renal failure

重症急性胰腺炎是临床上一种常见的急腹症，其具有病理复杂、发病急、发展快等特征，并且很容易引发多脏器功能障碍综合征（MODS）和全身炎症反应综合征（SIRS），致死率非常高，可达20%～30%［1］。……