武鹏宇,刘俊,王琼
WU Pengyu,LIU Jun,WANG Qiong

• 1:成都市第三人民医院消化内科
• 2:四川省林业中心医院消化科

摘要(Abstract)：

目的 探讨不同时点液体复苏治疗对重症急性胰腺炎(NSAP)患者的疗效。方法 收集117例NSAP患者的临床资料，依据液体复苏治疗时点分为对照组(腹痛开始12 h后)69例和观察组(腹痛开始8 h内)48例，统计两组患者生命体征恢复时间、住院时间、禁食禁水时间、住院费用，比较两组患者液体复苏治疗期间的多器官衰竭(MODS)发生率、重症胰腺炎(SAP)、全身炎症反应(SIRS)发生率、转入ICU、死亡、介入操作及接受机械通气发生率等临床转归情况；于液体复苏治疗前、治疗后7 d时检测血肌酐(SCr)、尿素氮(BUN)、淀粉酶(AMY)及C反应蛋白(CRP)水平。结果 观察组生命体征恢复时间、住院时间、禁食禁水时间均短于对照组，MODS发生率、AMY、CRP水平均低于对照组，住院费用均少于对照组，差异有统计学意义(P<0.05);观察组SCr、BUN水平高于对照组，差异有统计学意义(P<0.05);观察组SAP、SIRS、介入操作、接受机械通气发生率均低于对照组，但差异无统计学意义(P>0.05)。结论 早期于腹痛开始8 h内对NSAP患者进行液体复苏治疗疗效较好。
Objective To investigate the curative effect of fluid resuscitation at different time points on patients with non-severe acute pancreatitis(NSAP). Methods Clinical data of 117 patients with NSAP were collected. According to the time point of fluid resuscitation treatment, the patients were divided into control group(treated at 12 h after the onset of abdominal pain, n=69) and observation group(treated within 8 h after the onset of abdominal pain, n=48). The recovery time of vital signs, length of hospital stay, the time of fasting and water deprivation and hospitalization expenses of two groups were documented. Clinical outcomes were compared between two groups, including the incidence rates of multiple organ dysfunction syndrome(MODS), severe acute pancreatitis(SAP), systemic inflammatory response syndrome(SIRS), transfer to ICU, death, interventional operation, and mechanical ventilation, etc. Serum creatinine(SCr), blood urea nitrogen(BUN), amylase(AMY), and C-reactive protein(CRP) were measured before and 7 days after fluid resuscitation treatment. Results The recovery time of vital signs, length of hospital stay, the time of fasting and water deprivation, the incidence rates of MODS, SCr, BUN, AMY, CRP, and hospitalization expenses in observation group were less than those in control group(P<0.05). The levels of SCr and BUN in observation group were higher than those in control group(P<0.05). The incidence of SAP, SIRS, interventional procedures, and mechanical ventilation in observation group was lower than those in control group(P>0.05).Conclusion Early fluid resuscitation for NSAP patients within 8 hours after the onset of abdominal pain has a good curative effect.

关键词(KeyWords)： 超早期液体复苏治疗;非重症急性胰腺炎;复苏效果;生化指标
ultra-early fluid resuscitation;non-severe acute pancreatitis(NSAP);resuscitation effect;biochemical index

Abstract:

Keywords:

基金项目(Foundation): 四川省卫生和计划生育委员会科研课题(18PJ391)

作者(Author): 武鹏宇,刘俊,王琼
WU Pengyu,LIU Jun,WANG Qiong

DOI: 10.19367/j.cnki.2096-8388.2023.02.018

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