Hiệu quả thay huyết tương ở bệnh nhân viêm tụy cấp do tăng triglyceride máu tại Khoa ICU Bệnh viện Đa khoa Trung tâm An Giang=Efficacy of plasma exchange in patients with acute pancreatitis due to hypertriglyceridemia at the ICU department of An Giang central general hospital

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Tác giả: Ngọc Kiếu Phạm

Ngôn ngữ: vie

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Thông tin xuất bản: Tạp chí Y dược học Cần Thơ, 2024

Mô tả vật lý: tr.8-12

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ID: 244964

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Hypertriglyceridemia is the third most common cause of acute pancreatitis. Plasma exchange is an effective treatment for reducing blood triglycerides rapidly. Objectives: To assess plasma exchange's effectiveness in treating hypertriglyceridemic acute pancreatitis. Materials and methods: The patients were diagnosed with acute pancreatitis due to hypertriglyceridemia. The study describes a series of cases, triglyceridemia levels before and after plasma exchange were compared. SOFA, Ranson, and BISAP scores were performed upon ICU admission and after plasmapheresis. Results: From 2021 to 2022, there were 20 patients, 85% men, 15% women
Average age 38.90 ± 6.7 years old. Triglycerides decreased from 20.36 ± 15.99mmol/L to 5.59 ± 2.71 mmol/L during the first plasma exchange and to 2.71 ± 1.77 mmol/L after the second plasma exchange (p <
0.001). The average ICU stay was 4 ± 2.2 days. A hospital death was not reported. SOFA score decreased significantly from 7 ± 1.5 points at admission to 2.29 ± 0.8 points at the time of transferring the patient out of the ICU (p<
0.001). BISAP score at admission was 3.15 ± 0.9 points and 2.9 ± 0.8 points at the time of transferring the patient out of the ICU (p <
0.001). Ranson criteria were 3.15 ± 0.7 points on admission and 1.8 ± 0.6 at the time of transferring the patient out of the ICU (p <
0.001). Conclusion: The treatment of acute hypertriglyceridemia-induced pancreatitis with plasma exchange is safe, effective, and fast. Concurrently this method also significantly improves the clinical outcomes of patients.Tăng triglyceride máu là nguyên nhân phổ biến thứ ba gây viêm tụy. Thay huyết tương là một phương pháp điều trị hiệu quả để giảm nhanh nồng độ triglyceride trong máu. Mục tiêu nghiên cứu: Đánh giá hiệu quả của việc thay huyết tương trong điều trị viêm tụy cấp do tăng triglyceride máu. Đối tượng và phương pháp nghiên cứu: Các bệnh nhân được chẩn đoán viêm tụy cấp do tăng triglyceride máu. Phương pháp nghiên cứu mô tả hàng loạt ca. Nồng độ triglyceride trong máu trước và sau khi thay huyết tương được so sánh. Thang điểm SOFA, Ranson và BISAP đã được thực hiện khi nhập ICU và sau khi thay huyết tương. Kết quả: Từ 2021 đến 2022 có 20 bệnh nhân, nam giới 85%, nữ 15%
tuổi trung bình 38,90 ± 6,7 tuổi. Triglyceride đã giảm từ 20,36 ± 15,99 mmol/L xuống 5,59 ± 2,71 mmol/L trong lần thay huyết tương thứ nhất và xuống còn 2,71 ±1,77 mmol/L sau lần thay huyết tương thứ hai (p <
0,001). Thời gian nằm viện ICU trung bình là 4 ± 2,2 ngày. Tỷ lệ tử vong trong bệnh viện là 0%. Điểm SOFA giảm từ 7 ± 1,5 điểm khi nhập viện xuống 2,29 ± 0,8 điểm khi chuyển trại (p <
0,001). Điểm BISAP khi nhập viện là 3,15 ± 0,9 điểm và 2,9 ±0,8 khi chuyển trại (p <
0,001). Tiêu chí Ranson là 3,15 ± 0,7 điểm khi nhập viện và 1,8 ± 0,6 khi chuyển khoa (p <
0,001). Kết luận: Thay huyết tương điều trị viêm tụy cấp do tăng triglyceride là phương pháp điều trị hiệu quả, nhanh chóng và an toàn. Đồng thời phương pháp này còn cải thiện đáng kể kết quả lâm sàng của bệnh nhân.

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