PDF下载 ( 1907 KB)
Research advances in continuous blood purification in treatment of severe acute pancreatitis
-
摘要:
重症急性胰腺炎(SAP)是一种病程凶险、预后不佳的疾病,尽管多年来医疗技术不断进步,但其病死率仍居高不下。连续性血液净化作为近30年来血液净化领域的最新成就,在治疗SAP方面取得了很大进展,但亦存在许多争议,其治疗效果、机制等仍需进一步探讨。综述了近年来连续性血液净化治疗SAP的相关研究,并对其治疗机制、治疗模式以及治疗效果作一阐述。
Abstract:Severe acute pancreatitis( SAP) is a disease with dangerous course and poor prognosis,and although medical technology keeps improving over the years,the mortality rate of SAP remains high. As the latest achievement in the field of blood purification over the past 30 years,continuous blood purification has made great achievements in the treatment of SAP; however,there are still many controversies,and further studies are needed to explore therapeutic effect and mechanism. This article reviews the studies on continuous blood purification in the treatment of SAP in recent years and elaborates on its therapeutic mechanism,treatment mode,and treatment effect.
-
Key words:
- pancreatitis /
- hemofiltration /
- therapeutics
-
[1] BANKS PA,BOLLEN TL,DERVENIS C,et al. Classification of acute pancreatitis—2012:Revision of the Atlanta classification and definitions by international consensus[J]. Gut,2013,62(1):102-111. [2] van SANTVOORT HC,BAKKER OJ,BOLLEN TL,et al. A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome[J]. Gastroenterology,2011,141(4):1254-1263. [3] TAN JW,GAO Y,KOW AWC,et al. Clinical management and outcomes of acute pancreatitis:Identifying areas for quality improvement in a tertiary Asian setting[J]. Pancreatology,2019,19(4):507-518. [4] WILKMAN E,KAUKONEN KM,PETTILV,et al. Early hemodynamic variables and outcome in severe acute pancreatitis:A retrospective single-center cohort study[J]. Pancreas,2013,42(2):272-278. [5] JOHNSON CD,ABU-HILAL M. Persistent organ failure during the first week as a marker of fatal outcome in acute pancreatitis[J]. Gut,2004,53(9):1340-1344. [6] LEPPNIEMI A,TOLONEN M,TARASCONI A,et al. 2019WSES guidelines for the management of severe acute pancreatitis[J]. World J Emerg Surg,2019,14:27. [7] JIANG HL,XUE WJ,LI DQ,et al. Influence of continuous veno-venous hemofiltration on the course of acute pancreatitis[J]. World J Gastroenterol,2005,11(31):4815-4821. [8] HU Y,XIONG W,LI C,et al. Continuous blood purification for severe acute pancreatitis:A systematic review and meta-analysis[J]. Medicine(Baltimore),2019,98(12):e14873. [9] MO QF. Research progress of etiology and pathogenesis in severe acute pancreatitis[J]. Chin J Gastroenterol Hepatol,2014,23(9):1107-1110.(in Chinese)磨庆福．重症急性胰腺炎的发病原因及发病机制研究进展[J]．胃肠病学和肝病学杂志，2014,23(9):1107-1110. [10] YAN XW,LI WQ,WANG H,et al. Effects of high-volume continuous hemofiltration on experimental pancreatitis associated lung injury in pigs[J]. Int J Artif Organs,2006,29(3):293-302. [11] SENDLER M,van den BRANDT C,GLAUBITZ J,et al. NLRP3 inflammasome regulates development of systemic inflammatory response and compensatory anti-inflammatory response syndromes in mice with acute pancreatitis[J]. Gastroenterology,2020,158(1):253-269. [12] DUAN PY,MA Y,LI XN,et al. Inhibition of RIPK1-dependent regulated acinar cell necrosis provides protection against acute pancreatitis via the RIPK1/NF-κB/AQP8 pathway[J].Exp Mol Med,2019,51(8):1-17. [13] RYCHTER JW,van MINNEN LP,VERHEEM A,et al. Pretreatment but not treatment with probiotics abolishes mouse intestinal barrier dysfunction in acute pancreatitis[J]. Surgery,2009,145(2):157-167. [14] SCRIHNER BH,CANER JE,BUTRI R,et al. The technique of continuous hemodialysis[J]. Trans Am Soc Artif Intern Organs,1960,6:88-103. [15] ZHOU HJ,LIU SB,SHU JJ. Effect of continuous plasma filtration adsorption in the treatment of severe acute pancreatitis[J]. China Med Herald,2019,16(4):92-95,99.(in Chinese)周恒杰，刘思伯，舒姣洁．连续性血浆滤过吸附对重症急性胰腺炎细胞因子的调节作用[J]．中国医药导报，2019,16(4):92-95,99. [16] RIMMELT,KELLUM JA. High-volume hemofiltration in the intensive care unit:A blood purification therapy[J]. Anesthesiology,2012,116(6):1377-1387. [17] WANG S,XU L,FENG X,et al. Is continuous venovenous hemofiltration effective against severe acute pancreatitis?[J].Artif Organs,2013,37(7):615-622. [18] DAI SR,LI Z,ZHANG JB. Serum interleukin 17 as an early prognostic biomarker of severe acute pancreatitis receiving continuous blood purification[J]. Int J Artif Organs,2015,38(4):192-198. [19] ZHANG Y,ZENG WZ,WANG YX,et al. Effect of continuous blood purification in treatment of patients with severe acute pancreatitis and multiple organ dysfunction syndrome[J]. J Clin Hepatol,2016,32(2):320-323.(in Chinese)张勇，曾维政，王云侠，等．连续性血液净化治疗重症急性胰腺炎合并多器官功能障碍综合征的效果观察[J]．临床肝胆病杂志，2016,32(2):320-323. [20] WHITLOCK R,TEOH K,VINCENT J,et al. Rationale and design of the steroids in cardiac surgery trial[J]. Am Heart J,2014,167(5):660-665. [21] SCHEFOLD JC,von HAEHLING S,PSCHOWSKI R,et al. The effect of continuous versus intermittent renal replacement therapy on the outcome of critically ill patients with acute renal failure(CONVINT):A prospective randomized controlled trial[J]. Crit Care,2014,18(1):r11. [22] FU JJ,ZHU HL,CHEN F,et al. Continuous blood purification for third-space fluid retention-based intra-abdominal hypertension[J]. J Nanchang Univ(Medical Sciences),2014,54(2):48-52,77.(in Chinese)傅建军，朱宏亮，陈帆，等．连续性血液滤过在治疗以第三间隙液体潴留为主的腹腔高压中的应用[J]．南昌大学学报(医学版)，2014,54(2):48-52,77. [23] LI XQ,WU YY,LI X,et al. Clinical effect of continuous blood purification in treatment of severe acute pancreatitis[J]. Clin J Med Offic,2019,47(7):677-679.(in Chinese)李晓茜，邬艺渊，李希，等．连续性血液净化治疗重症急性胰腺炎临床效果观察[J]．临床军医杂志，2019,47(7):677-679. [24] LI F. Effects of continuous blood purification on hemorheoloy and serum inflammatory cytokines in patients with severe acute pancreatitis and MODS[J]. Sichuan Med J,2018,39(5):579-582.(in Chinese)李峰．连续性血液净化对重症急性胰腺炎合并MODS患者血液流变学及血清炎症因子的影响[J]．四川医学，2018,39(5):579-582. [25] LI W,YAN X,WANG H,et al. Effects of continuous high-volume hemofiltration on experimental severe acute pancreatitis in pigs[J]. Pancreas,2007,34(1):112-119. [26] VESCONI S,CRUZ DN,FUMAGALLI R,et al. Delivered dose of renal replacement therapy and mortality in critically il patients with acute kidney injury[J]. Crit Care,2009,13(2):r57. [27] UCHINO S,TOKI N,TAKEDA K,et al. Validity of low-intensity continuous renal replacement therapy[J]. Crit Care Med,2013,41(11):2584-2591. [28] LIU C,LI M,CAO S,et al. Effects of HV-CRRT on PCT,TNF-α，IL-4,IL-6,IL-8 and IL-10 in patients with pancreatitis complicated by acute renal failure[J]. Exp Ther Med,2017,14(4):3093-3097. [29] ABULIMITI A,HUSAIYIN A,SAILAI Y. Evaluation of HVHF for the treatment of severe acute pancreatitis accompanying MODS[J]. Medicine(Baltimore),2018,97(1):e9417. [30] GUO J,HUANG W,YANG XN,et al. Short-term continuous high-volume hemofiltration on clinical outcomes of severe acute pancreatitis[J]. Pancreas,2014,43(2):250-254. [31] ZHANG HB,WANG XD,SHI HN. Determination of the application of CBP therapy performed on SAP by monitoring inflammatory cytokines[J]. Acta Univ Med Nanjing(Natural Science),2016,36(2):205-209.(in Chinese)张海滨，王旭东，史海娜．炎性细胞因子监测在判断CBP治疗SAP时机选择中的应用[J]．南京医科大学学报(自然科学版)，2016,36(2):205-209. [32] LUO JY,WANG XY,JIANG WF,et al. The optimal timing of continuous venovenous hemofiltration combined with hemoperfusion for the treatment of patients with acute pancreatitis[J].Chin J Blood Purificat,2016,15(12):664-668.(in Chinese)罗建宇，王晓源，蒋文芳，等．连续性静脉-静脉血液滤过联合血液灌流治疗急性胰腺炎时机的研究[J]．中国血液净化，2016,15(12):664-668. [33] QIU ZQ,GAO Q. Selection of appropriate period of blood purification for patients with hyperlipidemic pancreatitis[J]. J Chongqing Med Univ,2016,41(6):598-601.(in Chinese)邱竹箐，高青．高脂血症性胰腺炎行血液净化时机选择[J]．重庆医科大学学报，2016,41(6):598-601. [34] Pancreas Study Group,Chinese Society of Gastroenterology,Chinese Medical Association; Editorial Board of Chinese Journal of Pancreatology; Editorial Board of Chinese Journal of Digestion. Chinese guidelines for the management of acute pancreatitis(Shenyang,2019)[J]. J Clin Hepatol,2019,35(12):2706-2711.(in Chinese)中华医学会消化病学分会胰腺疾病学组，《中华胰腺病杂志》编委会，《中华消化杂志》编委会．中国急性胰腺炎诊治指南(2019年，沈阳)[J]．临床肝胆病杂志，2019,35(12):2706-2711. [35] XU J,TIAN X,ZHANG C,et al. Management of abdominal compartment syndrome in severe acute pancreatitis patients with early continuous veno-venous hemofiltration[J]. Hepatogastroenterology,2013,60(127):1749-1752. [36] XU J,CUI Y,TIAN X. Early continuous veno-venous hemofiltration is effective in decreasing intra-abdominal pressure and serum interleukin-8 level in severe acute pancreatitis patients with abdominal compartment syndrome[J]. Blood Purif,2017,44(4):276-282. [37] XU JM,YANG HD,TIAN XP. Effects of early hemofiltration on organ function and intra-abdominal pressure in severe acute pancreatitis patients with abdominal compartment syndrome[J]. Clin Nephrol,2019,92(5):243-249. [38] GUO H,SUO DW,ZHU HP,et al. Early blood purification therapy of severe acute pancreatitis complicated by acute lung injury[J]. Eur Rev Med Pharmacol Sci,2016,20(5):873-878. [39] NAIR S,YADAV D,PITCHUMONI CS. Association of diabetic ketoacidosis and acute pancreatitis:Observations in 100 consecutive episodes of DKA[J]. Am J Gastroenterol,2000,95(10):2795-2800. [40] WANG HL,YU KJ. Sequential blood purification therapy for critical patients with hyperlipidemic severe acute pancreatitis[J]. World J Gastroenterol,2015,21(20):6304-6309. [41] SUN S,HE L,BAI M,et al. High-volume hemofiltration plus hemoperfusion for hyperlipidemic severe acute pancreatitis:A control ed pilot study[J]. Ann Saudi Med,2015,35(5):352-358. [42] ZHANG HY,ZHANG Y. The observation of curative effect of CBP at bedside for pregnancy complicating SAP[J]. China Med Equipment,2018,15(5):75-79.(in Chinese)张红英，张怡．床旁持续血液净化对妊娠合并重症急性胰腺炎的疗效观察[J]．中国医学装备，2018,15(5):75-79. [43] CLARK E,MOLNAR AO,JOANNES-BOYAU O,et al. Highvolume hemofiltration for septic acute kidney injury:A systematic review and meta-analysis[J]. Crit Care,2014,18(1):r7. [44] GAO SMITH F,PERKINS GD,GATES S,et al. Effect of intravenousβ-2 agonist treatment on clinical outcomes in acute respiratory distress syndrome(BALTI-2):A multicentre,randomised controlled trial[J]. Lancet,2012,379(9812):229-235. [45] RAN F,WU J,NIU X,et al. A new approach for membrane modification based on electrochemically mediated living polymerization and self-assembly of N-tert-butyl amide-andβ-cyclodextrin-involved macromolecules for blood purification[J]. Mater Sci Eng C Mater Biol Appl,2019,95:122-133. [46] MANSUR S,OTHMAN MHD,ISMAIL AF,et al. Synthesis and characterisation of composite sulphonated polyurethane/polyethersulphone membrane for blood purification application[J]. Mater Sci Eng C Mater Biol Appl,2019,99:491-504. -
本文二维码
计量
- 文章访问数: 801
- HTML全文浏览量: 25
- PDF下载量: 154
- 被引次数: 0
下载:
