| Objective: Severe acute pancreatitis(Severe acute pancreatitis,SAP)onset and condition changes rapidly,progress is fast,high mortality,patients often due to Multiple Organ failure(Multiple outraged Dysfunction Syndrome,MODS)and serious infections and death.SAP in the early stage of acute reaction,namely the systemic inflammatory response syndrome((SIRS),and in the pathogenesis and disease development play an important role in the process,its start and systemic inflammatory response syndrome factor for inflammatory factors,such as interleukin 6(IL-6),tumor necrosis factor alpha(TNF alpha).At the same time,often in the early with serum urea nitrogen(BUN),creatinine(Cr)levels.Its pathogenesis and kidney cells in patients with ischemic anoxia,inflammatory cytokines release,bacterial toxins and cell factor is activated after the renal medulla cell membrane and the renal tubular damage,at the same time also with renin angiotensin system activation and hemodynamic changes in microcirculation system dysfunction.If not timely take effective measures to treat the aggravating and often result in systemic inflammatory response syndrome,including acute kidney injury,multiple organ dysfunction,is one of the important factors of prognosis of SAP patients.But how inflammation factors interact with each other and promote pancreatitis course of progressive evolution and remote organs complication produces the detailed mechanism is not very clear.Clinical treatment according to the functions of viscera damage using protection and support,immunomodulatory cytokines and hemofiltration is exploring study,in view of the microcirculation,and inflammatory mediator release and cell factor of the pathogenesis of in-depth study,makes every effort to block the occurrence of MODS,as early as possible to promote the body function recovery quickly.Therefore,clinical doctors should strengthen on severe acute pancreatitis serum interleukin 6(IL-6),tumor necrosis factor alpha(TNF alpha)and serum urea nitrogen(BUN),creatinine(Cr)levels of early detection,strengthen understanding,vigilance,early diagnosis,early treatment,avoid may increase systemic inflammatory response syndrome and acute kidney injury factors.Methods: Selected patients were divided into group A and group B,30 cases in each group,group A(treatment group)has given blood will net injection injection 100 ml intravenous drip,1 every 8 hours,3 times/day.Group B(control group)to blood will net injection injection.More than two groups of patients with the same treatment,all adopt water fasting,gastrointestinal decompression,antispasmodic and analgesic,lien inhibition of pancreatic enzyme secretion,prevent abdominal cavity infection,maintain water electrolyte and acid-base balance and other conventional treatment.Application of automatic biochemical analyzer to detect serum amylase,and USES the method of double antibody sandwich enzyme-linked immuneosorbent(ELISA)determination of serum interleukin 6(IL-6),tumor necrosis factor alpha(TNF alpha)and conventional test of serum urea nitrogen(BUN),Cr level.Statistical records on admission and 3 and 7 days in the two groups after treatment in patients with serum urea nitrogen(BUN),creatinine(Cr),serum interleukin 6(IL-6),tumor necrosis factor alpha levels(TNF alpha).1 Compared two groups of severe acute pancreatitis patients with renal insufficiency(serum Cr > 97.2 mu mol/L as renal insufficiency)incidence;2 Different onset time was hospitalized patients in treatment group used blood will net injection effect evaluation;3 In treatment group and control group in patients with renal insufficiency in the venous blood IL-6,TNF alpha,BUN and Cr level statistical analysis,to explore the blood will be a net injection of two groups of patients serum inflammatory factor and the influence of creatinine and urea nitrogen,provide the basis for guiding clinical treatment.Results: According to divided the patients into disease incidence after admission time within 24 hours after admission group(< 24 h group)and 24 to 72 hours in hospital group(24-72-h group)and 72 hours after admission group(> 72 h group).Each time the treatment group compared with control group the incidence of renal insufficiency were lower(P < 0.05).And early in the treatment group are blood admissions,the earlier application shall be net injection,the lower the incidence of renal insufficiency.Early application of blood will net injection injection can reduce renal insufficiency in patients with severe acute pancreatitis.For patients with renal insufficiency,the control group,treatment group of patients during treatment the serum IL-6,and the level of BUN and Cr first change trend of rise and fall,and between different time points difference was statistically significant(P < 0.05).Control group and treatment group after treatment 3 to 5 days and 7-9 days testing,the difference was statistically significant(P < 0.05).Appeared in the process of two groups of patients in the treatment of different levels of IL-6,and elevated BUN,Cr,but the degree of blood will net injection treatment group than those in control group and quick recovery(P < 0.05),especially in the 7 days significantly(P < 0.01).Conclusion:1 Serum IL-6? and BUN?Cr with SAP progress is on the rise.2 In SAP when blood will net injection injection on serum and IL-6 and other mediators of inflammation and activation cause certain restriction,blocking "waterfall" effect of the inflammatory response in the SAP,to establish a proinflammatory and anti-inflammatory cytokine equilibrium relationship between.3 Xuebijing will be effective injection injection can reduce BUN,Cr level. |
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