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目的观察早期血浆置换对重症高脂血症性胰腺炎(HLP)的生化指标改变及治疗效果。方法 40例重症高脂血症性胰腺炎患者,随机分为对照组23例和治疗组17例。对照组采用内科传统治疗;治疗组在对照组的基础上给予早期单次床旁血浆置换治疗。比较两组血患者常规白细胞(WBC)、血清淀粉酶(AMY)、血糖(GLU)、甘油三酯(TG)指标。结果治疗前,两组患者血常规WBC、AMY、TG、GLU比较,差异无统计学意义(P>0.05)。治疗后第3天,两组患者血常规WBC、AMY、TG、GLU低于治疗前(P<0.01);治疗组血常规WBC(7.89±1.53)×109/L、AMY(201.32±18.20)U/L、GLU(7.15±0.98)mmol/L、TG(5.82±3.01)mmol/L均低于对照组的(9.26±2.06)×109/L、AMY(252.43±19.08)U/L、GLU(8.43±1.66)mmol/L、TG(11.72±3.64)mmol/L(P<0.05)。结论重症高脂血症性胰腺炎患者采用早期行血浆置治疗能明显改善其生化指标,减少炎症反应发生,阻止病情发展。
Objective To observe the changes of biochemical indexes and treatment effect of early plasma exchange on severe hyperlipidemic pancreatitis (HLP). Methods Forty patients with severe hyperlipidemic pancreatitis were randomly divided into control group (23 cases) and treatment group (17 cases). The control group received traditional medical treatment; the treatment group was given an early single-bedside plasma exchange based on the control group. The routine white blood cells (WBC), serum amylase (AMY), blood glucose (GLU) and triglyceride (TG) were compared between the two groups. Results Before treatment, there was no significant difference in WBC, AMY, TG and GLU between the two groups (P> 0.05). The WBC, AMY, TG and GLU in the two groups were lower than those before treatment on the third day after the treatment (P <0.01). The WBC in the treatment group was 7.89 ± 1.53 × 109 / L, and the AMY was 201.32 ± 18.20 U (9.2 ± 2.06) × 109 / L, AMY (252.43 ± 19.08) U / L, GLU (7.1 ± 0.08) mmol / L and TG 8.43 ± 1.66 mmol / L, TG 11.72 ± 3.64 mmol / L, P <0.05). Conclusion Severe hyperlipidemic pancreatitis in patients with early plasma plasma therapy can significantly improve their biochemical parameters, reduce the incidence of inflammatory reactions, to prevent the progression of the disease.