重症急性胰腺炎应用限制性液体复苏治疗的效果分析  

Effect analysis of restrictive fluid resuscitation in severe acute pancreatitis

作　　者：张新转 ZHANG Xin-zhuan(Department of Critical Care Medicine,Chaoyang Central Hospital,Chaoyang 122000,China)

机构地区：[1]朝阳市中心医院重症医学科,122000

出　　处：《中国实用医药》2022年第15期58-60,共3页China Practical Medicine

摘　　要：目的 分析重症急性胰腺炎患者应用限制性液体复苏治疗的临床效果。方法 80 例重症急性胰腺炎患者,随机分为对照组和观察组,各 40 例。对照组行单纯早期液体复苏治疗,观察组行限制性液体复苏治疗。比较两组临床指标[腹腔内压 (IAP)、72 h 输液量、尿量、中心静脉压 (CVP)、平均动脉压 (MAP)、红细胞比容 (HCT) ]改善情况及并发症发生情况。结果 观察组 IAP(12.50±2.87)mm Hg(1 mm Hg=0.133 k Pa) 低 于 对 照 组 的 (15.93±3.62)mm Hg,72 h 输 液 量 (8520.35±125.35)ml和 尿 量 (5061.65±135.65)ml 均 少 于 对 照 组 的 (10961.35±132.65)、(5224.35±154.65)ml,CVP(15.34±3.19)cm H_(2)O(1 cm H_(2)O=0.098 k Pa)、MAP(80.34±7.98)mm Hg 和 HCT(33.24±4.35)% 均 高 于 对 照 组 的(13.11±3.15)cm H_(2)O、(74.20±8.35)mm Hg、(30.32±3.65)%,差异具有统计学意义 (P<0.05)。观察组急性呼吸窘迫综合征 (ARDS) 发生率 2.50% 和急性冠状动脉综合征 (ACS) 发生率 5.00% 均低于对照组的17.50%、20.00%,差异具有统计学意义 (P<0.05)。结论 给予重症急性胰腺炎患者限制性液体复苏治疗能够改善患者循环血容量,预防患者出现严重性并发症,具有推广价值。Objective To analyze the clinical effect of restrictive fluid resuscitation in severe acute pancreatitis.Methods A total of 80 patients with severe acute pancreatitis were randomly divided into control group and observation group,with 40 cases in each group.The control group received simple early fluid resuscitation,while the observation group received restrictive fluid resuscitation.Both groups were compared in terms of clinical indicators[intra-abdominal pressure(IAP),72 h infusion volume,urine volume,central venous pressure(CVP),mean arterial pressure(MAP),hematocrit(HCT)]improvement and complications.Results The IAP(12.50±2.87)mm Hg(1 mm Hg=0.133 kPa)of the observation group was lower than(15.93±3.62)mm Hg of the control group;the 72 h infusion volume(8520.35±125.35)ml and the urine volume(5061.65±135.65)ml were less than(10961.35±132.65)and(5224.35±154.65)ml of the control group;the CVP(15.34±3.19)cm H_(2)O(1 cm H_(2)O=0.098 kPa),MAP(80.34±7.98)mm Hg and HCT(33.24±4.35)%were higher than(13.11±3.15)cm H_(2)O,(74.20±8.35)mm Hg,and(30.32±3.65)%of the control group;all the differences were statistically significant(P<0.05).The incidence of acute respiratory distress syndrome(ARDS)in the observation group was 2.50%and the incidence of acute coronary syndrome(ACS)was 5.00%,which were lower than 17.50%and 20.00%in the control group,and the differences were statistically significant(P<0.05).Conclusion Restrictive fluid resuscitation can improve the circulating blood volume and prevent severe complications in patients with severe acute pancreatitis,which has the value of popularization.

关 键 词：重症急性胰腺炎 限制性液体复苏 单纯早期液体复苏 

分 类 号：R576[医药卫生—消化系统]