羟乙基淀粉联合乳酸钠林格注射液在重症急性胰腺炎患者早期液体复苏治疗中的应用效果  

Application effect of hydroxyethyl starch combined with sodium lactate ringer′s injection on early fluid resuscitation in patients with severe acute pancreatitis

作　　者：彭传荣 周翔 PENG Chuanrong;ZHOU Xiang(Department of Critical Care Medicine,Sanming First Hospital Affiliated to Fujian Medical University,Fujian Province,Sanming 365000,China)

机构地区：[1]福建医科大学附属三明第一医院重症医学科,福建省三明市365000

出　　处：《临床合理用药杂志》2023年第15期27-30,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 观察羟乙基淀粉联合乳酸钠林格注射液在重症急性胰腺炎(SAP)患者早期液体复苏治疗中的应用效果。方法 按照计算机分组法将2020年7月—2022年4月福建医科大学附属三明第一医院收治的81例SAP患者分为对照组(n=40)和观察组(n=41)。对照组予以乳酸钠林格注射液行早期液体复苏治疗,观察组在对照组基础上给予羟乙基淀粉130/0.4氯化钠注射液治疗,2组均持续治疗24 h。比较2组血液净化时间、机械通气时间,治疗前后膀胱压、炎性因子水平、血流动力学指标。结果 观察组血液净化、机械通气时间短于对照组(P<0.05或P<0.01)。治疗12 h、24 h后,2组膀胱压低于治疗前,且观察组低于对照组(P<0.05或P<0.01)。治疗24 h后,2组血清白介素-6(IL-6)、白介素-8(IL-8)水平低于治疗前,且观察组低于对照组(P<0.01)。治疗24 h后,2组胸腔内血容积指数(ITBVI)、中心静脉压(CVP)高于治疗前,肺血管通透性指数(PVPI)、血细胞比容(HCT)低于治疗前,且观察组升高/降低幅度大于对照组(P<0.05P<0.01)。结论 SAP患者在早期液体复苏治疗中应用羟乙基淀粉联合乳酸钠林格注射液能够有效抑制炎性反应,改善血流动力学,降低膀胱压,促进疾病快速恢复。Objective To explore application effect of hydroxyethyl starch combined with sodium lactate ringer′s injection on early fluid resuscitation in patients with severe acute pancreatitis(SAP).Methods A total of 81 cases of patients with SAP were selected from July 2020 to April 2022 in Sanming First Hospital Affiliated to Fujian Medical University,which were divided into the control group(n=40)and the observation group(n=41)according to computer grouping method.The control group was treated with sodium lactate ringer′s injection for early fluid resuscitation,and the observation group was treated with hydroxyethyl starch 130/0.4 and sodium chloride injection on the basis of the control group.Both groups were treated continuously for 24 hours.The blood purification time,mechanical ventilation time,bladder pressure,inflammatory factors level and hemodynamic indexes before and after treatment were compared between the two groups.Results The blood purification time and mechanical ventilation time in the observation group were shorter than those in the control group(P<0.05 or P<0.01).After 12 hours and 24 hours of treatment,the bladder pressure in the two groups was lower than that before treatment,and that in the observation group was lower than control group(P<0.05 or P<0.01).After 24 hours of treatment,the serum levels of IL-6 and IL-8 in the two groups were lower than those before treatment,and those in the observation group were lower than control group(P<0.01).After 24 hours of treatment,the ITBVI and CVP of the two groups were higher than those before treatment,while the PVPI and HCT were lower than those before treatment,and the increase/decrease range of the observation group were greater than those of the control group(P<0.05 or P<0.01).Conclusion In the early fluid resuscitation treatment of SAP patients,hydroxyethyl starch combined with sodium lactate ringer′s injection can effectively inhibit inflammatory reaction,improve hemodynamics,reduce bladder pressure and promote disease recovery.

关 键 词：重症急性胰腺炎 早期液体复苏 乳酸钠林格注射液 羟乙基淀粉 治疗结果 

分 类 号：R576[医药卫生—消化系统]