• 四川省人民醫(yī)院肝膽胰外科,四川成都 610072;

摘要:目的:探討急性重癥胰腺炎(SAP)早期不同種類液體復(fù)蘇對(duì)其預(yù)后的影響。方法:應(yīng)用隨機(jī)對(duì)照的方法,分別對(duì)2007年12月~2009年10月同期入院的48例SAP患者,隨機(jī)分成兩組,試驗(yàn)組和對(duì)照組。試驗(yàn)組第一周內(nèi)液體復(fù)蘇采用晶體液和人工膠體(羥乙基淀粉),對(duì)照組采用晶體液,其他治療方法不變。然后統(tǒng)計(jì)其第一周死亡率、ARDS、多器官功能障礙綜合征(MODS)發(fā)生率,對(duì)比兩組患者呼吸頻率、血氧飽和度和紅細(xì)胞壓積(HCT)差異,以及兩組患者腸功能恢復(fù)時(shí)間、住院時(shí)間以及并發(fā)癥發(fā)生率。結(jié)果:試驗(yàn)組的液體復(fù)蘇較對(duì)照組顯著改善SAP的各項(xiàng)指標(biāo)(P<005)。血清乳酸水平(15±05)mmol/L,
紅細(xì)胞壓積(HCT)為(324±69)%,ScvO2為(817±152)%,病死率83%,MODS發(fā)生率333%,〖HT5”H〗結(jié)論:〖HT5”SS〗 SAP早期聯(lián)合應(yīng)用晶膠體進(jìn)行液體復(fù)蘇可有效恢復(fù)循環(huán)血容量和防止體液潴留,顯著提高其治愈率。
Abstract: Objective: To investigate the optimal strategy of fluid resuscitation in the early stage ofsevere acute pancreatitis.〖WT5”HZ〗Methods:〖WT5”BZ〗Fourfyeighs SAP patients who received treatment in our hospital from 12,2007 to 10,2009 were randomly divided into 2 groups (n=24) according to the different amounts of crystal and colloid inthe daily resuscitation,including crystal group,combined group(the ratio of crystal to colloid was 2 to 1).The levels of hematocrit(HCT),saturation of central
vein oxygen ( ScvO2 ),serum lactic acid as well as the advent of negative flui
d balance the amount of fluid contained in the third space,mortality rate and th
e incidence of multiple organ dysfunction syndrome(MODS) in different groups wer
e compared.〖WT5”HZ〗Results:〖WT5”BZ〗 Compared with crystal group,all the p
arameters were significantly improved in combined group(P<005).HCT in th
e group of patients was(324±69)%,ScvO2 was (817±152)%,lactic aci
d was(15±05)mmol/L,mortality rate was 83% and MODS incidence was 333%. Conclusion:In the early stage of SAP,fluid resuscitation by a combination of crystal and colloid could effectively restore blood volume, reduce the amount of fluid contained in the third space and significantly improve the prognosis of SAP.

引用本文: 溫爾剛,董科,余小炯. 重癥急性胰腺炎早期液體復(fù)蘇的臨床研究. 華西醫(yī)學(xué), 2009, 24(12): 3121-3123. doi: 復(fù)制