重症急性胰腺炎的早期液体复苏  

Early fluid resuscitation in severe acute pancreatitis

作　　者：王缓缓 石斌 Wang Huanhuan;Shi Bin(Department of Emergency Intensive Care Unit,Yangpu District Central Hospital of Shanghai(YangPu Hospital Affiliated to Tongji University),Shanghai 200090,China)

机构地区：[1]上海市杨浦区中心医院(同济大学附属杨浦医院)急诊ICU,上海200090

出　　处：《中华医学杂志》2021年第30期2356-2359,共4页National Medical Journal of China

基　　金：上海市卫生健康委员会基金项目(201840314)。

摘　　要：早期液体复苏是重症急性胰腺炎(SAP)治疗的基石,液体复苏的终点需多途径、多角度评估与把握。SAP早期液体复苏需要综合临床指标、压力指标、容量指标、微循环及组织氧代谢指标等各个监测参数,动态评估容量反应性与耐受性,监测大循环及微循环的灌注状态,把握复苏的阶段性,及时调整液体的晶胶比、速度等,防止过度补液导致肺水肿、腹腔高压等并发症,以不断提高SAP早期液体复苏的有效性和安全性。Fluid resuscitation is the cornerstone in the early treatment of severe acute pancreatitis(SAP).The endpoints of fluid therapy should be closely monitored early in the disease course by different methods,such as clinical status,pressure indicators,volume indicators,the maintain of microcirculation and the tissue oxygenation.To avoid volume overload that may lead to complications such as pulmonary edema and abdominal hypertension,it is critical to adjust the ratio of crystalloid-colloid and the speed of the liquid timely according to the dynamically assessment of fluid responsiveness and tolerance,the perfusion of macrocirculation and microcirculation and the stage of the fluid resuscitation,so as to improve the efficacy and safety of early fluid resuscitation in the treatment of SAP.

关 键 词：胰腺炎 急性坏死性 急性循环衰竭 液体复苏 血流动力学监测 微循环 

分 类 号：R576[医药卫生—消化系统]