限制性液体复苏对急性胰腺炎患者血乳酸值及胃肠功能的影响

Effect of limited fluid resuscitation on blood lactic acid value and gastrointestinal function in patients with acute pancreatitis

目的探讨限制性液体复苏对急性胰腺炎（AP）患者血乳酸值及胃肠功能的影响。方法选取2013年6月至2015年6月本院收治的AP患者96例，将其随机分为两组，每组48例，对照组应用开放性液体复苏治疗，观察组应用限制性液体复苏治疗。对比两组血乳酸值、胃肠功能及血流动力学。结果治疗24h、48h、72h后观察组血乳酸值分别为（2．02±0．84）mmol／L、（1．09±0．73）mmol／L、（0．63±0．12）mmol／L，均明显低于对照组的（4．52±1．62）mmol／L、（3．29±1．25）mmol／L、（2．18±1．14）mmol／L，差异均有统计学意义；观察组胃肠功能改善总有效率为93．75％，明显高于对照组的79．17％，差异有统计学意义；观察组心率、平均动脉压及24h尿量分别为（86．94±11．63）次／min、（64．92±13．47）mmHg、（1447．38±126．42）ml，均明显低于对照组的（98．41±12．35）次／min、（78．24±12．76）mmHg、（1601．05±134．26）ml，差异均有统计学意义。结论AP患者在急救过程中应用限制性液体复苏可明显改善组织器官血流灌注，降低血乳酸值，改善胃肠功能，值得应用。

Objective To explore the effect of limited fluid resuscitation on blood lactic acid value and gastrointestinal function in patients with acute pancreatitis （AP）. Methods 96 patients with AP treated at our hospital from June, 2013 to June, 2015 were randomly divided into a control group and an observation group, 48 cases for each group. The control group were treated with open fluid resuscitation and the observation group limited fluid resuscitation. The blood lactic acid value, gastrointestinal function, and hemodynamics were compared between these two groups. Results After the treatment, the blood lactic acid value was significantly lower, the total effective rate of gastrointestinal function improvement was higher, and the hemodynamics was better in the observation group than in the control group, with statistical differences （P 〈 0.05）. Conclusions Limited fluid resuscitation in the emergency treatment of patients with AP can significantly improve the blood perfusion of tissue and organ, decrease the value of blood lactic acid, and improve gastrointestinal function, si it is worth being applied.