不同时点液体复苏治疗对重症急性胰腺炎患者的疗效分析

Analysis of Therapeutic Effects of Fluid Resuscitation at Different Time Points on Patients with Severe Acute Pancreatitis

目的 探讨重症急性胰腺炎(severe acute pancreatitis,SAP)不同时点液体复苏治疗的价值。方法 回顾性选取2023年3月—2024年3月泗阳医院收治的80例NSAP患者的临床资料,按复苏时间分为两组,每组40例,早期组在腹痛8 h内行复苏治疗,晚期组在腹痛12 h后行复苏治疗,比较两组的临床指标、生化指标及转归情况。结果 早期组的禁食禁水、体征恢复以及住院时间短于晚期组,差异有统计学意义(P均<0.05)。与晚期组相比,早期组的肌酐水平更高,淀粉酶、C反应蛋白更低,差异有统计学意义(P均<0.05)。早期组的多器官衰竭率为0,低于晚期组的15.00%(6/40),机械通气率为0,低于晚期组的15.00%(6/40),ICU转入率为2.50%(1/40),低于晚期组的20.00%(8/40),差异有统计学意义(χ^(2)=4.504、4.504、4.507,P均<0.05)。结论 腹痛8 h内与复苏12 h后行液体复苏治疗均能挽回SAP患者生命,其中腹痛8 h内治疗能减少预后不良事件,纠正生化代谢状态,缩短住院周期。

Objective To investigate the value of pancreatitis(SAP) characterized by fluid resuscitation at different time points.Methods The clinical data of eighty NSAP patients admitted to Siyang Hospital from March 2023 to March 2024 were retrospectively selected and divided into two groups according to the resuscitation time,with forty cases in each group.The early group received resuscitation treatment within 8 h of abdominal pain,and the late group received resuscitation treatment 12 h after abdominal pain.The clinical indicators,biochemical indicators and outcomes of the two groups were compared.Results Fasting and water deprivation,recovery of physical signs and hospitalization time in the early group were shorter than those in the late group,and the differences were statistically significant(all P<0.05).Compared with the late group,the creatinine level in the early group was higher,amylase and Creactive protein were lower,and the differences were statistically significant(all P<0.05).The rate of multiple organ failure in the early group was 0,lower than 15.00%(6/40) in the late group,mechanical ventilation rate was 0,lower than 15.00%(6/40) in the late group,ICU transfer rate was 2.50%(1/40),lower than 20.00%(8/40) in the late group,and the differences were statistically significant(χ~2=4.504,4.504,4.507,all P<0.05).Conclusion Liquid resuscitation therapy within 8 h of abdominal pain and 1 h after resuscitation can save the life of patients with SAP,and treatment within 8 h of abdominal pain can reduce prognostic adverse events,correct biochemical and metabolic status,and shorten the hospitalization period.