早期液体复苏达标对急性胰腺炎临床预后的影响  

Effect of early fluid resuscitation on the clinical prognosis in patients with acute pancreatitis

作　　者：王洁[1] 吴青[1] 罗秀平 梁成海 彭鹏[1] 梁志海[2] 黄杰安[1] 覃蒙斌[1] WANG Jie;WU Qing;LUO Xiu-ping;LIANG Chen-ghai;PENG Peng;LIANG Zhi-hai;HUANG Jie-an;QIN Meng-bin(Department of Gastroenterology,the Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,China;Department of Gastroenterology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第二附属医院消化内科,1530007 [2]广西医科大学第一附属医院消化内科,2530021

出　　处：《现代消化及介入诊疗》2021年第11期1356-1359,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：国家自然科学基金(81960126);广西自然科学基金(2018GXNSFBA281154);广西卫生健康委员会自筹经费科研课题(Z20210625);广西医科大学第二附属医院科学基金(EFYKY2020007)。

摘　　要：目的探讨早期液体复苏达标对急性胰腺炎患者临床预后的影响。方法回顾性分析2018—2020年广西医科大学第二附属医院收治的124例急性胰腺炎患者的临床资料,根据液体复苏达标的5个指标,将平均动脉压>65 mm Hg、心率<120次/min、尿素氮(BUN)<7.14 mmol/L、红细胞压积(HCT)≥0.35且≤0.44、尿量>0.5 m L·kg^(-1)·h^(-1)的患者归为复苏达标组(59例,47.58%),上述指标未达以上标准的患者归为复苏未达标组(65例,52.42%)。比较两组患者的临床资料。结果复苏达标组急性坏死物积聚、急性肾损伤发生率分别为5.08%、8.47%,显著低于复苏未达标组的23.08%和24.62%(P均<0.05)。复苏未达标组重症急性胰腺炎(SAP)发生率为27.69%,显著高于复苏达标组的11.86%(P<0.05)。结论早期液体复苏达标可以减少胰腺坏死,降低急性肾损伤和SAP的发生率,改善急性胰腺炎患者的临床预后。Objective To investigate the effect of early fluid resuscitation on the clinical prognosis of patients with acute pancreatitis.Methods A retrospective study was performed for the clinical data of 124 patients with acute pancreatitis who were admitted to the Second Affiliated Hospital of Guangxi Medical University from 2018 to 2020.According to five indicators of the fluid resuscitation target of mean arterial pressure,heart rate,blood urea nitrogen(BUN),hematocrit(HCT)and urine volume,the patients were divided into recovery standard group(n=59)and recovery non-standard group(n=65).Clinical data of the two groups were compared.Results In terms of local complications and systemic complications,the incidence of acute necrotic collection and acute kidney injury in the recovery standard group was 5.08%and 8.47%,respectively significantly lower than that in the recovery non-stansard group 23.08%and 24.62%(all P<0.05).The incidence of severe acute pancreatitis(SAP)in the recovery nonstandard group was 27.69%,which was significantly higher than that in the recovery group11.86%(P<0.05).Conclusion Sucessful early fliud resuscitation can reduce pancreatic necrosis and the incidence of AKI and SAP and can improve clinical outcome in patients with acute pancreatitis.

关 键 词：早期液体复苏 达标 急性胰腺炎 预后 并发症 

分 类 号：R576[医药卫生—消化系统]