外科理论与实践

外科理论与实践 ›› 2018, Vol. 23 ›› Issue (01): 37-40.doi: 10.16139/j.1007-9610.2018.01.009

• 论著 • 上一篇    下一篇

早期控制性液体复苏对急性重症胰腺炎预后的影响

孙文武, 祁梦之, 毛恩强   

  1. 上海交通大学医学院附属瑞金医院急诊重症监护,上海 200025
  • 收稿日期:2017-05-08 出版日期:2018-01-25 发布日期:2020-07-25
  • 通讯作者: 毛恩强,E-mail: maoeq@yeah.net

Effect of early and controlling fluid resuscitation on prognosis of severe acute pancreatitis

SUN Wenwu, QI Mengzhi, MAO Enqiang   

  1. Emergency Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2017-05-08 Online:2018-01-25 Published:2020-07-25

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摘要： 目的 评估早期控制性液体复苏达标是否对急性重症胰腺炎（SAP）病人临床结局产生有利影响。方法 选择2012年至2017年间本院急诊重症监护室SAP病人共61例,为发病72 h内住院。按早期控制性液体复苏是否达标分达标组（38例）和未达标组（23例）。比较两组病人临床结果的差异。结果 达标组与未达标组数据的基线水平无统计学差异。达标组24 h静脉输液量显著多于未达标组[（5 493±1 887） mL比（3 967±1 203） mL,P<0.05]。达标组总体死亡率（18.4%）显著低于未达标组（47.8%）（P<0.05）。7 d内达标组肾功能衰竭发生率（21.1%比60.9%,P<0.05）、住院期间外科干预率（23.6%比56.5%,P<0.05）显著优于未达标组。但两组病人在机械通气时间（P=0.23）、7 d内呼吸功能衰竭（P=1.00）和循环功能衰竭（P=0.27）的差异无统计学意义。结论 早期控制性液体复苏达标可显著降低SAP病人的总死亡率、7 d内肾功能衰竭发生率以及住院期间外科干预率。

关键词: 液体复苏, 急性重症胰腺炎, 临床预后

Abstract: Objective To explore the effect of early and controlling fluid resuscitation on clinical prognosIs of the patients with severe acute pancreatitis(SAP). Methods A total of 61 patients with SAP treated within 72 hours attack in Emergency Intensive Care Unit between 2012 and 2017 were included and divided into ccntrol group and uncontrol group according to whether or not reaching the goals of early and controlling fluid resuscitation. Control group included 38 patients and uncontrol group included 23 patients. Prognosis of the patients was compared between 2 groups. Results There was no obvious difference of baseline between 2 groups. The patients in control group received more fluid infusion than in uncontrol group (5 493±1 887 vs 3 967±1 203, P<0.05). The patients in control group had lower mortality than in uncontrol group (18.4% vs 47.8%, P<0.05) and lower rate of renal failure within 7 days (21.1% vs 60.9%, P<0.05), surgical intervention rate (23.6% vs 56.5%, P<0.05). There was no difference in both groups of duration of mechanical ventilation(P=0.23), pulmonary(P=1.00) and circulatory failure rate within 7 days(P=0.27). Conclusions The patients with SAP reached the goals of early and controlling fluid resuscitation might have lower mortality, lower rate of renal failure within 7 days and surgical intervention rate compared with the patients in uncontrol group,

Key words: Fluid resuscitation, Severe acute pancreatitis, Clinical prognosis

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