早期液体复苏达标对急性胰腺炎患者临床预后的影响  

Effect of early fluid resuscitation up to standard on clinical prognosis of patients with acute pancreatitis

作　　者：袁晓庆[1] YUAN Xiao-qing(Department of Gastroenterology,Sheyang County People's Hospital,Yancheng 224300,China)

机构地区：[1]江苏省盐城市射阳县人民医院消化内科,224300

出　　处：《中国实用医药》2023年第16期54-57,共4页China Practical Medicine

摘　　要：目的探究早期液体复苏达标对于急性胰腺炎患者预后的影响。方法50例急性胰腺炎患者作为研究对象,根据液体复苏是否达标分为实验组(26例,液体复苏达标)和对照组(24例,液体复苏未达标)。两组患者均接受常规治疗及早期液体复苏治疗。比较两组患者治疗前后生化指标[白细胞介素-10(IL-10)、白细胞计数(WBC)、血清淀粉酶(AMS)、血清脂肪酶(LPS)]水平,各项临床评分[Ranson评分、急性生理学及慢性健康状况评分系统II(APACHEⅡ)评分、急性胰腺炎的CT严重度指数(CTSI)评分],并发症发生情况,重症急性胰腺炎(SAP)发生情况。结果治疗前,两组患者IL-10、WBC、AMS、LPS水平比较差异无统计学意义(P>0.05);治疗后,实验组IL-10、WBC、AMS、LPS分别为(39.27±4.55)ng/L、(11.12±1.21)×10^(9)/L、(887.62±45.25)U/L、(79.11±8.24)U/L,均低于对照组的(45.31±6.36)ng/L、(13.48±1.79)×10^(9)/L、(958.46±51.57)U/L、(86.74±7.62)U/L,差异具有统计学意义(P<0.05)。实验组Ranson评分(3.02±1.05)分、APACHEⅡ评分(9.11±2.43)分、CTSI评分(4.23±1.33)分均低于对照组的(3.81±1.35)、(10.45±2.05)、(5.06±1.54)分,差异具有统计学意义(t=2.3197、2.0984、2.0441,P=0.0247、0.0412、0.0465<0.05)。实验组并发症发生率7.69%(2/26)低于对照组的37.50%(9/24),差异具有统计学意义(P<0.05)。实验组SAP发生率3.85%低于对照组的29.17%,差异具有统计学意义(χ^(2)=5.9533,P=0.0147<0.05)。结论急性胰腺炎患者早期液体复苏达标能够有效改善其生化指标、减少并发症,利于预后效果的提升,值得推广。Objective To investigate the effect of early fluid resuscitation up to standard on clinical prognosis of patients with acute pancreatitis.Methods A total of 50 patients with acute pancreatitis were studied and divided into experimental group(26 cases,fluid resuscitation up to standard)and control group(24 cases,fluid resuscitation not up to standard)according to whether fluid resuscitation was up to standard.Patients in both groups received conventional treatment and early fluid resuscitation treatment.Both groups were compared in terms of levels of biochemical indexes[interleukin-10(IL-10),white blood cell count(WBC),serum amylase(AMS),serum lipase(LPS)],various clinical scores[Ranson score,Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score,CT severity index(CTSI)score],the occurrence of complications,and the occurrence of severe acute pancreatitis(SAP).Results Before treatment,there was no statistically significant difference between the two groups in terms of IL-10,WBC,AMS and LPS levels(P>0.05).After treatment,IL-10,WBC,AMS and LPS were(39.27±4.55)ng/L,(11.12±1.21)×10^(9)/L,(887.62±45.25)U/L and(79.11±8.24)U/L in the experimental group,which were lower than those of(45.31±6.36)ng/L,(13.48±1.79)×10^(9)/L,(958.46±51.57)U/L and(86.74±7.62)U/L in the control group,and the differences were statistically significant(P<0.05).In the experimental group,the Ranson score was(3.02±1.05)points,the APACHEⅡscore was(9.11±2.43)points and the CTSI score was(4.23±1.33)points,which were all lower than those of(3.81±1.35),(10.45±2.05)and(5.06±1.54)points in the control group,and the differences were statistically significant(t=2.3197,2.0984,2.0441;P=0.0247,0.0412,0.0465<0.05).The incidence of complications of the experimental group was 7.69%(2/26),which was lower than that of 37.50%(9/24)of the control group,and the difference was statistically significant(P<0.05).The incidence of SAP in the experimental group was 3.85%,which was lower than that of 29.17%in the control group,and the difference wa

关 键 词：早期液体复苏达标 急性胰腺炎 临床预后 影响 

分 类 号：R576[医药卫生—消化系统]