血浆交换维持凝血功能以防止急性重度酒精性胰腺炎患者MODS恶化:1例报告

Ping Xiao, Tao Xu , Ming Zhou , ZhenYu Lei
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引用次数: 0

摘要

背景急性重度酒精性胰腺炎不经血液净化死亡率高。患者与方法:我们采用血浆置换联合持续静脉-静脉血液滤过治疗1例重症急性胰腺炎合并多器官功能障碍综合征患者。结果分析治疗期间肝、肾、凝血、心、炎症等血液指标。经CVVH + PE治疗后,患者血清ALT、TBIL、IB、DB、Cr、WBC、N、HCRP、LDH、CK、PLT均恢复正常。凝血指标补充血浆置换后,PLT、PT、INR、FIB、AT3、DDI均有明显改善。结论血浆置换可能有助于清除循环有害分子,减轻大范围全身炎症反应,促进凝血机制恢复正常,调节血流动力学稳定性,从而重新平衡凝血功能,缓解急性重度酒精性胰腺炎多脏器功能障碍综合征不可逆恶化的进展。我们的病例首先强调了PE和CVVH治疗SAP患者MODS的潜在疗效。这些治疗在改善临床状况,特别是保持凝血稳定方面起着至关重要的作用。CVVH和PE是治疗SAP患者的有效方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Plasma exchange maintains coagulation function to prevent worsening of MODS in a patient with acute severe alcoholic pancreatitis: A case report

Background

Acute severe alcoholic pancreatitis has a high mortality rate without blood purification. Patient and method: We used plasma exchange and continuous venovenous hemofiltration to treat a patient with severe acute pancreatitis complicated by multiple organ dysfunction syndrome.

Results

Blood indicators of liver, kidney, coagulation, heart, and inflammation were analyzed during treatment. The blood levels of ALT, TBIL, IB, DB, Cr, WBC, N, HCRP, LDH, CK, and PLT were restored after the patient received treatment with CVVH + PE. PLT, PT, INR, FIB, AT3, and DDI were significantly improved when the coagulation indicators were supplemented by plasma exchange.

Conclusion

Plasma exchange may help remove harmful circulating molecules, mitigate the large-scale systemic inflammatory response, facilitate the restoration of normal coagulation mechanisms, and regulate hemodynamic stability, thereby rebalancing coagulation function and alleviating the progression of irreversible deterioration in multiple organ dysfunction syndrome for patients with acute severe alcoholic pancreatitis. Our case first highlights the potential efficacy of both PE and CVVH in treating MODS in SAP. These treatments play a vital role in improving clinical conditions, especially in keeping coagulation stable. CVVH and PE are effective treatments for the SAP patient.
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