论文部分内容阅读
目的:探讨急性重症胰腺炎(SAP)早期不同种类液体复苏对其预后的影响。方法:应用随机对照的方法,分别对2007年12月～2009年10月同期入院的48例SAP患者,随机分成两组,试验组和对照组。试验组第一周内液体复苏采用晶体液和人工胶体(羟乙基淀粉),对照组采用晶体液,其他治疗方法不变。然后统计其第一周死亡率、ARDS、多器官功能障碍综合征(MODS)发生率,对比两组患者呼吸频率、血氧饱和度和红细胞压积(HCT)差异,以及两组患者肠功能恢复时间、住院时间以及并发症发生率。结果:试验组的液体复苏较对照组显著改善SAP的各项指标(P<0.05)。血清乳酸水平(1.5±0.5)mmol/L,红细胞压积(HCT)为(32.4±6.9)%,ScvO2为(81.7±15.2)%,病死率8.3%,MODS发生率33.3%,结论:SAP早期联合应用晶胶体进行液体复苏可有效恢复循环血容量和防止体液潴留,显著提高其治愈率。
Objective: To investigate the effect of different kinds of liquid resuscitation on the prognosis of patients with acute severe pancreatitis (SAP). Methods: Forty-eight SAP patients admitted in the same period from December 2007 to October 2009 were randomly divided into two groups: experimental group and control group. In the first week of the experimental group, liquid and artificial gel (hydroxyethyl starch) were used for liquid resuscitation, and the crystalloid solution was used for the control group. Other treatment methods remained unchanged. Then the first week mortality, ARDS and MODS were compared. The difference of respiratory rate, oxygen saturation and hematocrit (HCT) between the two groups were compared, and the intestinal function recovery Time, hospital stay and complication rate. Results: The liquid resuscitation in the experimental group significantly improved the indexes of SAP compared with the control group (P <0.05). Serum lactate level was (1.5 ± 0.5) mmol / L, hematocrit (HCT) was (32.4 ± 6.9)%, ScvO2 was (81.7 ± 15.2)%, mortality was 8.3%, incidence of MODS was 33.3% The combination of crystalloid for liquid resuscitation can effectively restore the circulating blood volume and prevent fluid retention, significantly improve the cure rate.