早期血浆置换治疗高脂血症性急性胰腺炎的临床意义 目的 探讨早期血浆置换(plasma exchange,PE)对高脂血症性急性胰腺炎(acute hyperlipidemic pancreatitis,HLP)的治疗作用。 办法 将 42 例 HLP 患者随机分为两组,治疗组 22 例(常规治疗+早期 PE),对照组 20 例采用常规治疗。比较 PE 两组患者血清甘油三酯(TG)浓度、急性生理和慢性健康评价指标Ⅱ(APACHE Ⅱ)评分、C-反映蛋白(CRP)浓度变化,并观察两组患者的临床体现和预后。 成果 入院 24 h,两组患者血清 TG 浓度较入院时均减少,且治疗组血清 TG 浓度明显低于对照组( P<0.01);入院 48 h,治疗组APACHE Ⅱ 评分、CRP 浓度均低于对照组(P=0.032;P=0.017);治疗组患者腹痛、腹胀缓和时间,禁食水时间,住院时间均较对照组缩短(P<0.01);治疗组及对照组的病死率分别为 9.1%、25.0%,两者比较差别无统计学意义(P=0.333)。 结论 早期 PE 可明显减少患者血清 TG 浓度,改善患者的临床症状,是治疗 HLP 的安全、有效的手段之一。 标签: 高脂血症性急性胰腺炎; 血浆置换; 甘油三酯 The clinical effects of the earlier plasma exchange in the treatment of hyperlipidemic acute pancreatitis ZHOU Ming-yin , CHEN Tao , WANG Yong-guang.The Central Hospital of XinYang,XinYang 464000,China 【Abstract】 Objective To evaluate the effect of earlier plasma exchange in the treatment of patients with The hyperlipidemic acute panercatitis (HLP). Methods 42 patients with HLP were divided into 2 groups: the treatment group(22cases)was given the conventional therapy and the plasma exchange ; the control group(20 cases)was given the only conventional therapy. and then The triglyceride levels in serum、the sorces of acute physiology and chronic health evaluation Ⅱ as well as the C-reactive protein levels in serum were compared before and after the plasma exchange respectively. their clinical features and prognosis were also observed. Results After 24 hours in hospital , triglyceride serum leve...