早期体液复苏治疗重症急性胰腺炎的疗效观察

Observation on Curative Effects of Early Fluid Resuscritation in Treatment of Severe Acute Pancreatitis

目的:探讨早期体液复苏在治疗重症急性胰腺炎中的应用价值。方法:选择2013年1月—2015年6月收治的64例重症急性胰腺炎患者作为研究对象,按随机数字表法分为观察组和对照组,每组32例。对照组患者给予常规治疗,观察组患者在对照组基础上给予早期体液复苏,观察两组患者治疗效果、并发症发生情况及死亡情况。结果:治疗后,两组患者Ranson评分、急性生理与慢性健康评分和CT严重指数评分均较治疗前明显改善,且观察组患者各指标改善程度明显优于对照组,差异均有统计学意义(P<0.05);两组患者的中心静脉压、平均动脉压、每小时尿量及混合静脉血氧饱和度均较治疗前明显改善,且观察组患者各指标改善情况明显优于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者心率、红细胞比容、血清乳酸水平均较治疗前显著降低,且观察组患者显著低于对照组,差异均有统计学意义(P<0.05)。观察组患者并发症发生率为18.75%(6/32),明显低于对照组的43.75%(14/32),差异有统计学意义(P<0.05)。两组患者死亡率的差异无统计学意义(P>0.05)。结论:重症急性胰腺炎患者应用早期液体复苏治疗的效果较好,并发症较低。

OBJECTIVE： To probe into the application value of early fluid resuscitation in treatment of severe acute pancreatitis. METHODS： 64 patients with severe acute pancreatitis from January 2013 to June 2015 were extracted and divided into observation group and control group via random number table,with 32 cases each group. The control group was treated with conventional therapy,and the observation group was given early fluid resuscitation on the basis of conventional therapy. Curative effects,complications and death of two groups were observed. RESULTS： After treatment,the Ranson score,APACHE Ⅱ score and CTSI score of two groups were significantly increased,and the observation group were significantly higher than those of the control group,with statistically significant difference（ P〈0. 05）. The CVP,MAP,urine volume and ScvO_2 of two groups were significantly increased,and the observation group were significantly higher than those of the control group,with statistically significant difference（ P〈0. 05）. The incidence of complications in the observation group（ 18. 75%,6/32） was significantly lower than that of the control group（ 43. 75%,14/32）,with statistically significant difference（ P〈0. 05）. The death rate of two groups with no statistically significant difference（ P〈0. 05）. CONCLUSIONS： The curative effect of early liquid resuscitation in treatment of severe acute pancreatitis is remarkable,with low complication and low mortality.