發(fā)布時(shí)間：2018-05-29 21:28

  本文選題：持續(xù)性腎替代治療 + 重癥急性胰腺炎��； 參考：《浙江大學(xué)》2017年碩士論文

【摘要】：目的:觀察不同時(shí)機(jī)使用連續(xù)性腎替代治療(continuous renal replacement treat ment,CRRT)在重癥急性胰腺炎(sever acute pancreatitis,SAP)治療效果。方法:回顧2015年1月至2016年12月入住浙江大學(xué)醫(yī)學(xué)院附屬邵逸夫醫(yī)院重癥醫(yī)學(xué)科(4F)46例符合中華醫(yī)學(xué)會(huì)胰腺外科組SAP診斷及分級(jí)標(biāo)準(zhǔn)且均接受CRRT治療的患者的臨床資料,分為早期治療組(A組)和晚期治療組(B組),均采用常規(guī)治療+CRRT。A組為一旦診斷明確為SAP即行CRRT,B組為出現(xiàn)急性腎損傷再行CRRT,統(tǒng)計(jì)分析兩組間的生命體征、實(shí)驗(yàn)室指標(biāo)、(sequential organ failure assessment,SOFA)SOFA 評(píng)分、(acute disease physiology and chronic health evaluation Ⅱ,APACHE Ⅱ)APACHE Ⅱ 評(píng)分、(modified CT severity index,MCTSI)MCTSI評(píng)分、28天死亡率、機(jī)械通氣時(shí)間等指標(biāo)分析CRRT介入時(shí)機(jī)與重癥急性胰腺炎患者預(yù)后的相關(guān)性。結(jié)果:A組與B組治療前的C-反應(yīng)蛋白比較(79.86±14.57 vs 84.47±12.23)、腹內(nèi)壓比較(14.3±4.16vs13.69±4.23)、APACHEⅡ 評(píng)分(13.82±3.44vs16.00±3.94)、SOFA評(píng)分(6.69±2.77vs8.34±2.88)等無統(tǒng)計(jì)學(xué)差異(P0.05);A組與B組治療后的比較C-反應(yīng)蛋白比較(14.6±4.84 vs 17.73±5.42)、腹內(nèi)壓比較(9.34±1.61 vs 10.60±1.97)、APACHE Ⅱ 評(píng)分(5.43±1.82vs9.78±2.67)、SOFA 評(píng)分(5.43±1.82 vs9.78±2.67)、機(jī)械通氣時(shí)間比較(7.82±1.85vs9.60±2.79)、28 天死亡率(4.35%vs13.04%)、總住院時(shí)間(25.21±7.68vs29.91±6.86)均有統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:早期行CRRT治療,可以降低SAP患者28天死亡率,減少住院時(shí)間。
[Abstract]:Objective: to observe the effect of continuous renal replacement treat replacement therapy (CRRT) in the treatment of severe acute pancreatitis (SAP). Methods: from January 2015 to December 2016, we reviewed the clinical data of 46 patients admitted to the Department of intensive Medicine of run Shaw Hospital affiliated to Zhejiang University Medical College from January 2015 to December 2016, who met the criteria of SAP diagnosis and grading in the pancreatic surgery group of the Chinese Medical Association and were treated with CRRT. The patients were divided into early treatment group (group A) and late treatment group (group B). Routine treatment of CRRT.A group was performed as soon as the diagnosis of SAP was confirmed, and then the occurrence of acute renal injury was performed in group B. The vital signs between the two groups were analyzed statistically. The laboratory parameters such as sequential organ failure assessment of SOFAFA score and acute disease physiology and chronic health evaluation 鈪，

本文編號(hào)：1952441