早期液体管理策略在急性胰腺炎患者中的临床效果  

Clinical Efficacy of Early Fluid Management Strategies in Patients with Acute Pancreatitis

作　　者：郑其朝 ZHENG Qichao(Majiang County People's Hospital,Qiandongnan Miao and Dong Autonomous Prefecture,Guizhou Province,557600)

机构地区：[1]麻江县人民医院,贵州黔东南557600

出　　处：《智慧健康》2025年第4期163-165,169,共4页Smart Healthcare

摘　　要：目的 探讨急性胰腺炎患者采取早期液体管理策略的临床效果。方法 选取2020年1月—2022年6月在本院诊治的70例急性胰腺炎患者为研究对象,依据入院24 h内控制性液体复苏的达标情况将其分为达标组和未达标组,每组35例。达标组采用早期积极液体复苏策略,迅速达到液体复苏达标标准[心率≤120次/min,平均动脉压(MAP)为65~85 mmHg,尿量≥1.0 mL/kg/h,血细胞比容(Hct)为30%~35%]。未达标组则采取限制性液体管理策略,主要目标是维持生命体征而不硬性地要求达标。比较两组患者的病情缓解时间、住院时间、并发症发生率。结果 达标组的病情缓解时间、住院时间均显著短于未达标组,且与未达标组相比,并发症发生率明显降低,炎症指标(CRP、白细胞计数)改善更为显著(P<0.05)。结论 早期液体管理策略在急性胰腺炎患者中具有重要的临床意义,能够有效缩短病情缓解时间,降低并发症发生率,对患者预后有积极的影响。Objective To explore the clinical role of early fluid management strategies in patients with acute pancreatitis and compare the differences in disease resolution,complication rates,and hospital stay between a compliant group receiving aggressive fluid resuscitation and a non-compliant group receiving restrictive fluid management.Methods Seventy patients with acute pancreatitis diagnosed and treated in our hospital between January 2020 and June 2022 were selected and divided into a compliant group and a non-compliant group based on whether they met the criteria for controlled fluid resuscitation within 24 hours of admission.The compliant group received an early aggressive fluid resuscitation strategy to rapidly meet the fluid resuscitation criteria(heart rate≤120 beats/min,mean arterial pressure 65-85 mmHg,urine output≥1.0 mL/kg/h,hematocrit 30%-35%).The non-compliant group received restrictive fluid management,primarily to maintain vital signs without actively pursuing the criteria.Disease resolution time,hospital stay,and complication rates were compared between the two groups.Results The compliant group had significantly shorter disease resolution time and hospital stay compared to the non-compliant group,with a notable reduction in complication rates and more significant improvement in inflammatory markers(CRP,white blood cell count)(P<0.05).Conclusion Early fluid management strategies hold significant clinical importance in patients with acute pancreatitis,effectively shortening disease resolution time,reducing complication rates,and positively impacting patient prognosis through the implementation of compliant fluid resuscitation.

关 键 词：急性胰腺炎 早期液体管理 临床研究 

分 类 号：R576[医药卫生—消化系统]