乳酸钠林格注射液在急性胰腺炎早期液体复苏中的应用价值  

Application value of Lactated Ringer's solution in early fluid resuscitation of acute pancreatitis

作　　者：李玉 蔡兆辉[1] 魏国峰[1] 张旗[1] 陈良[1] 陈辉 李军 李海山 LI Yu;CAI Zhao-hui;WEI Guo-feng(The Second People's Hospital of Hefei,Hefei 230000,China)

机构地区：[1]合肥市第二人民医院(安徽医科大学附属合肥医院)急诊科,合肥230000 [2]不详

出　　处：《肝胆外科杂志》2024年第5期346-349,共4页Journal of Hepatobiliary Surgery

摘　　要：目的技探讨乳酸钠林格注射液在急性胰腺炎早期液体复苏中的应用价值。方法回顾性分析2021年6月至2023年6月期间合肥市第二人民医院收治的182例急性胰腺炎(AP)的患者,并根据早期补液方法分为乳酸钠林格注射液组(LRS)组和生理盐水溶液(NSS)组。分析统计两组一般临床资料、局部并发症、器官衰竭病人数以及人院治疗后48小时的CRP水平、pH和HCO_(3)水平等资料。结果两组患者在年龄、性别、基础疾病史、APACHE I评分、Ranson评分、病因、人院时CRP方面没有显著差异,NSS组局部并发症和器官衰竭发生率均高于LRS组,但两组比较差异无统计学意义(P>0.05)。在AP严重程度方面,LRS组出现中度AP的频率显著低于NSS组(P=0.015)。两组住院时间差异无统计学意义。两组CRP水平在48小时内均有所升高,然而LRS组早期液体复苏治疗后与NSS组相比,LRS组的患者在第48小时的CRP水平较低(P=0.012)。尽管复苏48小时后两组患者的pH和HCO,水平变化在正常范围内,但与NSS组复苏患者相比,LRS患者的pH和HCO,水平变化有利于代谢性酸中毒(P=0.022)。结论LRS对AP的严重程度有积极的影响,并具有抗炎作用。Objectives To investigate the application value of Lactated Ringer's solution in early fluid resuscitation of acute pan-creatitis.Methods A retrospective analysis was performed on 182 patients with acute pancreatitis admitted to the Second People's Hos-pital of Hefei City from June 2021 to June 2023,and they were divided into Lactated Ringer's solution group(LRS)and normal saline solution(NSS)group according to early fluid rehydration method.The general clinical data,local complications,organ failure,CRP levels,pH and HCO_(3) levels 48 hours after admission were analyzed and analyzed.Results There were no significant differences between the two groups in age,gender,underlying disease history,APACHEII score,Ranson score,etiology,and CRP on admission.The incidence of local complications and organ failure in NSS group was higher than that in LRS group,but there was no statistically significant difference between the two groups(P>0.05).In terms of AP severity,the frequency of moderate AP was significantly lower in the LRS group than in the NSS group(P=0.015).There was no significant difference in length of stay between the two groups.CRP levels were elevated in both groups at 48 hours,however,patients in the LRS group had lower CRP levels at 48 hours after early fluid resuscitation compared with those in the NSS group(P=0.012).Although changes in pH and HCO,levels were within the normal range in both groups 48 hours after resuscitation,changes in pH and HCO,levels in LRS patients favored metabolic acidosis compared with resuscitation patients in the NSS group(P=0.022).Conclusion LRS has a positive effect on the severity of AP and has an antiinflammatory effect.

关 键 词：急性胰腺炎 液体复苏 乳酸钠林格注射液 

分 类 号：R659[医药卫生—外科学]