液体复苏在早期急性胰腺炎合并糖尿病治疗中的应用效果

Effect of fluid resuscitation on early acute pancreatitis with diabetes mellitus

目的探讨液体复苏在早期急性胰腺炎合并糖尿病患者治疗中的应用效果。方法选取2017年9月至2019年7月在平顶山市第一人民医院治疗的84例急性胰腺炎患者。所有患者均合并糖尿病,将其分为对照组与观察组,每组42例。所有患者均给予常规综合治疗,对照组采取常规补液治疗,观察组采取早期液体复苏治疗。治疗后,比较两组患者的APACHEⅡ评分、Ranson评分系统、CTSI指数及急性肾损伤(AKI)、急性呼吸窘迫综合征(ARDS)、多器官功能障碍综合征(MODS)等并发症发生率和病死率。结果治疗后,观察组患者的急性生理和慢性健康评估Ⅱ评分(APACHEⅡ)、Ranson评分系统、CTSI指数均明显低于对照组,差异有统计学意义(P<0.05);观察组患者的AKI、ARDS、MODS并发症发生率(16.67%、19.05%、23.81%)及病死率(14.29%)均明显低于对照组的发生率(40.48%、45.24%、47.62%)及病死率(35.71%),差异有统计学意义(P<0.05)。结论对早期急性胰腺炎合并糖尿病患者采取液体复苏治疗可改善患者预后,减少并发症发生,治疗效果良好。

Objective To investigate the effect of fluid resuscitation on early acute pancreatitis with diabetes mellitus. Methods From September 2017 to July 2019, 84 patients with acute pancreatitis were selected from the First People’s Hospital of Pingdingshan. All patients with diabetes were divided into control group and observation group, with 42 cases in each group. All patients were given routine comprehensive treatment, the control group was treated with routine rehydration, and the observation group was treated with early fluid resuscitation. After treatment, the Apache Ⅱ score, Ranson scoring system, CTSI index, the incidence and mortality of complications such as acute renal injury(AKI), acute respiratory distress syndrome(ARDS), multiple organ dysfunction syndrome(MODS) were compared between the two groups.Results After treatment, the acute physiological and chronic health assessment Ⅱ(APACHE Ⅱ), Ranson scoring system and CTSI index of the observation group were significantly lower than those of the control group(P<0.05);the complications rate of AKI, ARDS and MODS in the observation group(16.67%, 19.05%, 23.81%) and mortality rate(14.29%) were significantly lower than those of the control group(40.48%, 45.24%,47.62%) and mortality rate(35.71%), the differences were significant(P<0.05).Conclusions Fluid resuscitation can improve the prognosis of patients with early acute pancreatitis and diabetes, reduce the incidence of complications, and the treatment effect is good.