早期控制性液体复苏在重症急性胰腺炎急救中的应用研究

Application of Early Controlled Fluid Resuscitation in Emergency Treatment of Severe Acute Pancreatitis

目的:研究重症急性胰腺炎(SAP)患者急救中早期控制性液体复苏的临床应用价值。方法:将笔者所在医院收治的86例SAP患者随机分为研究组(n=43)和对照组(n=43)。对照组患者行常规急救治疗,研究组患者在常规急救治疗的基础上联合早期控制性液体复苏治疗。比较两组临床疗效、治疗前后血清炎症因子[白细胞介素-8(IL-8)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]及并发症发生率。结果:研究组临床治疗总有效率为90.70%,高于对照组的72.09%,差异有统计学意义(P<0.05)。治疗后,研究组IL-8、CRP、TNF-α均低于对照组,差异有统计学意义(P<0.05)。研究组SIRS、MODS、感染性休克、胰腺坏死并发症总发生率为11.63%,低于对照组的27.91%,差异有统计学意义(P<0.05)。结论:于SAP患者急救中应用早期控制性液体复苏能有效改善微循环障碍,控制机体炎症反应,降低严重并发症发生率,进而提高急救效果。

Objective:To study the clinical application value of early controlled fluid resuscitation in emergency treatment of severe acute pancreatitis (SAP).Method:A total of 86 SAP patients admitted in our hospital were randomly divided into the study group (n=43) and the control group (n=43).Patients in the control group received routine emergency treatment.Patients in the study group received early controlled fluid resuscitation on the basis of routine emergency treatment.The clinical efficacy,serum inflammatory factors[interleukin-8 (IL-8),C-reactive protein (CRP),tumor necrosis factor-α (TNF-α)]before and after treatment and the incidence of complications were compared between the two groups.Result:The total effective rate of clinical treatment in the study group was 90.70%,which was higher than 72.09% in the control group,and the difference was statistically significant (P<0.05).After treatment,IL-8,CRP and TNF-α in the study group were lower than those in the control group,and the differences were statistically significant (P<0.05).The total incidence of complications of SIRS,MODS,septic shock and pancreatic necrosis in the study group was 11.63%,which was lower than 27.91% in the control group,and the difference was statistically significant (P<0.05).Conclusion:The application of early controlled fluid resuscitation in emergency treatment of SAP patients can effectively improve the microcirculation disorder,control the body’s inflammatory response,reduce the incidence of serious complications,and thus improve the emergency effect.