重症急性胰腺炎急性反应期液体复苏体会

The Experience of Severe Acute Pancreatitis During Acute Phase Reaction with Fluid Resuscitation

目的探讨重症急性胰腺炎急性反应期液体复苏的经验与体会。方法回顾性分析97例重症急性胰腺炎患者在急性反应期的液体复苏过程;观察复苏时间及治疗过程中出现呼吸衰竭、肾功能不全等并发症情况;对比输入胶体与晶体液的情况。结果对照组(A组,未输注胶体液)51例,呼吸衰竭19例,肾功不全16例,心功能不全10例,死亡5例。治疗组(B组,输注胶体液)46例,呼吸衰竭9例,肾功能不全8例,心功能不全3例,死亡2例。早期液体输入量及呼吸衰竭、肾功能衰竭等并发症均明显低于对照组。结论重症急性胰腺炎急性期液体复苏时及时补充胶体液能减少液体输入量,缩短复苏时间,早期限制性液体输入降低肺损伤等并发症的发生。

Objective To discuss the experience of fluid resuscitation of severe acute pancreatitis during acute phase. Methods 97 cases of severe acute pancreatitis in the acute phase with fluid resuscitation were retrospectively analyzed. Recovery time,respiratory failure, renal failure and other complications in the course of treatment were observed. The importation of colloidal solution and crystal liquid of two group were compared. Results The control group（ group A, no infusion of colloid）. Section 51 cases, 19 cases of respiratory failure, 16 cases of renal insufficiency, 10 cases of cardiac dysfunction ,5 cases of death. While the treatment group（ group B ,infusion colloid） 46 cases ,9 cases of respiratory failure ,8 cases of renal insufficiency,3 cases of cardiac diysfunction ,2 cases of death. Liquid volume early input and the incidence of respiratory failure, renal failure and other complications were significantly lower than the control group. Conclusion Severe acute pancreatitis during the acute phase with fluid resuscitation. Supply with colloidal solution timly can reduce the liquid volume input ,shorten recovery time, the importation of liquid early restrictively can lower the incidence of lung injury and other complications.