Clinical Study of Continous Veno-venous Hemofiltration(CVVH) and Repeated Intermittent Veno-Venous Hemofiltration (RIVVH) in Treatment of Severe Acute Pancreatitis(SAP)_West China Medical Journal

Authors：

NIE Xiaodong , WANG Chang song , LIU Mu , et al

Department of Nephrology, The Second Hospital of Yibing, Yibing Sichuan 644000, China;

Corresponding author：

Keywords：

重症急性胰腺炎; 连续性静脉-静脉血液滤过; 反复间断静脉一静脉血液滤过

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目的:研究早期连续性静脉-静脉血液滤过和反复间断静脉一静脉血滤治疗重症急性胰腺炎的临床价值。方法:45例SAP患者随机分为CVVH组(25例)和RIVVH组(20例)。比较2组患者的生命体征、生化指标、治疗前后的APACHE Ⅱ评分、死亡率、好转率。结果:CVVH 组中3例死于MODS,死亡率为12％,RIVVH组死亡3例 (15％),其差异有统计学意义(P lt;0.05);CVVH 组好转率为80％ (20/25),与RIVVH组的80％(16/20)一致。在治疗的早期阶段,对于改善生命体征,降低APACHEⅡ评分CVVH效果更显注,但随着治疗时间的延长,这种差异逐渐变小,在后期两组间不再存在疗效差异,最终疗效上没有明显的差异,而RIVVH组,在治疗费用和人员成本上具有优势。结论:早期RIVVH 治疗SAP可以作为SAP重要的辅助治疗措施。

Citation： NIE Xiaodong,WANG Chang song,LIU Mu,et al. Clinical Study of Continous Veno-venous Hemofiltration(CVVH) and Repeated Intermittent Veno-Venous Hemofiltration (RIVVH) in Treatment of Severe Acute Pancreatitis(SAP). West China Medical Journal, 2009, 24(4): 878-880. doi: Copy

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13.	YEKEBAS E F, EISENBERGER C E, OHNESORGE H, et al. Attenuation of sepsis related immunoparalysis by continuous veno-venous hemofiltration in experimental porcine panereatitis[J]. Cret Care Med,2001,29(1):423..
14.	YEKEBAS E F, STRATE T, ZOLMAJD S, et al. Impact of different modalities of continous venovenous hemofiltration on sepsis induced alteration in experimental pancreatitis[J]. Kidney Inter,2002,62(1):806.
15.	YEKEBAS E F, STRATE T, ZOLMAJD S, et al. Impact of different modalities of continous venovenous hemofiltration on sepsis induced alteration in experimental pancreatitis[J]. Kidney Inter,2002,62(1):806.
16.	谢红浪,李维勤.应用CVVH治疗重症急性胰腺炎[J].肾脏病与透析肾移植杂志,2000,9(6):510-515..
17.	谢红浪,李维勤.应用CVVH治疗重症急性胰腺炎[J].肾脏病与透析肾移植杂志,2000,9(6):510-515..
18.	姚欣敏,刘牧,李云涛,等.早期反复间断血滤治疗重症急性胰腺炎的临床研究[J].中国普外基础与临床杂志,2008,15(5),352-357,361..
19.	姚欣敏,刘牧,李云涛,等.早期反复间断血滤治疗重症急性胰腺炎的临床研究[J].中国普外基础与临床杂志,2008,15(5),352-357,361..

1.
2. CHAING DT,ANOZIE A,FLEMING W R, et al. Comparative study on acute pancreatitis management[J]. ANZ J Surg,2004,74(4):218-221..
3. KINGSNORTH A. Role of cytokines and their inhibitors in acute pancreatitis[J]. Gut,1997,40(1):1-4..
4. SCHETZ M R C. Classical and alternative indication for continuous renal replacement therapy[J]. Kindey Int,1998, 53 (66): 129-132.
5. 中华医学会外科学会胰腺外科学组.重症急性胰腺炎诊治草案[J].中国实用外科杂志,2001,21(9):513-514.
6. BONE R C, BALK R A, CERRA F B, et al. The ACCP/SCCM consensus conference committee. Definitions for sepsis and organ failure and guidelines for the use ofinnovative therapies in sepsis[J]. Chest,1992,101(5):1656-1662..
7. BONE R C, BALK R A, CERRA F B, et al. The ACCP/SCCM consensus conference committee. Definitions for sepsis and organ failure and guidelines for the use ofinnovative therapies in sepsis[J]. Chest,1992,101(5):1656-1662..
8. 黎磊石,季大玺.连续性血液净化[M].第一版,东南大学出版社,2004,11: 88-94..
9. 黎磊石,季大玺.连续性血液净化[M].第一版,东南大学出版社,2004,11: 88-94..
10. YEKEBAS E F, TREEDE H, KNOEFEl W T, et al.Influence of zero-balanced hemofiltration on the course of severe experimental pancreatitis in pigs[J]. Ann Surg,1999,22(9):514..
11. YEKEBAS E F, TREEDE H, KNOEFEl W T, et al.Influence of zero-balanced hemofiltration on the course of severe experimental pancreatitis in pigs[J]. Ann Surg,1999,22(9):514..
12. YEKEBAS E F, EISENBERGER C E, OHNESORGE H, et al. Attenuation of sepsis related immunoparalysis by continuous veno-venous hemofiltration in experimental porcine panereatitis[J]. Cret Care Med,2001,29(1):423..
13. YEKEBAS E F, EISENBERGER C E, OHNESORGE H, et al. Attenuation of sepsis related immunoparalysis by continuous veno-venous hemofiltration in experimental porcine panereatitis[J]. Cret Care Med,2001,29(1):423..
14. YEKEBAS E F, STRATE T, ZOLMAJD S, et al. Impact of different modalities of continous venovenous hemofiltration on sepsis induced alteration in experimental pancreatitis[J]. Kidney Inter,2002,62(1):806.
15. YEKEBAS E F, STRATE T, ZOLMAJD S, et al. Impact of different modalities of continous venovenous hemofiltration on sepsis induced alteration in experimental pancreatitis[J]. Kidney Inter,2002,62(1):806.
16. 谢红浪,李维勤.应用CVVH治疗重症急性胰腺炎[J].肾脏病与透析肾移植杂志,2000,9(6):510-515..
17. 谢红浪,李维勤.应用CVVH治疗重症急性胰腺炎[J].肾脏病与透析肾移植杂志,2000,9(6):510-515..
18. 姚欣敏,刘牧,李云涛,等.早期反复间断血滤治疗重症急性胰腺炎的临床研究[J].中国普外基础与临床杂志,2008,15(5),352-357,361..
19. 姚欣敏,刘牧,李云涛,等.早期反复间断血滤治疗重症急性胰腺炎的临床研究[J].中国普外基础与临床杂志,2008,15(5),352-357,361..

West China Medical Journal

Clinical Study of Continous Veno-venous Hemofiltration(CVVH) and Repeated Intermittent Veno-Venous Hemofiltration (RIVVH) in Treatment of Severe Acute Pancreatitis(SAP)

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