摘要
目的探讨血容量监测下早期目标导向性液体治疗(EGDT)在重症急性胰腺炎(SAP)中的应用。方法选取2010年1月～2012年10月在湖南省张家界市人民医院的SAP患者132例,随机分为观察组和对照组,每组各66例。在SAP急性反应期综合治疗的基础上,对照组予以传统液体复苏,观察组予以早期目标导向治疗,观察两组患者48 h液体输入量、48 h血乳酸(Lac)水平、达标后APACHEⅡ评分、血淀粉酶恢复时间、并发症发生率和28 d死亡率等。结果观察组48 h液体输入量、48 h LAc水平、血淀粉酶恢复时间、血管活性药物使用时间、机械通气时间均少于(或小于)对照组,达标后APACHEⅡ评分高于对照组,且并发症发生率和28 d死亡率均低于对照组,差异具有统计学意义(P<0.05或P<0.01)。结论血容量监测下早期目标导向性液体治疗能动态反映SAP患者的血流动力学状态,对提高临床疗效、降低并发症发生率和死亡率均具有重要的临床意义。
Objectives To explore the application of early goal-directed fluid resuscitation（EGDT） by blood volume monitoring in severe acute pancreatitis（SAP）.Methods 132 cases with SAP in Zhangjiajie People＇s Hospital from January 2010 to October 2012 were selected,and were divided into observation group and control group,66 cases per group.Patients in control group were given conventional fluid resuscitation on the basis of comprehensive treatment, and patients in observation group were given EGDT.Liquid input and blood lactic acid（LAc） in 48 h,APACHE Ⅱ score on reaching standard,serum amylase recovery time,complication rate and mortality in 28 d and so on were observed in two groups.Results Liquid input and blood LAc in 48 h,serum amylase recovery time,vasoactive drug use time,duration of mechanical ventilation in observation group were all less than those in control group,yet APACHE Ⅱ score on reaching standard was higher than that of control group,and complication rate and mortality in 28 d were lower than those in control group,and there were statistical difference（P 0.05 or P 0.01）.Conclusion It can reflect SAP patients′ hemodynamic status dynamically by EGDT,and it has important clinical significance on improving its clinical efficacy and reducing complication and mortality rate.
出处
《中国医药导报》
CAS
2013年第8期65-67,共3页
China Medical Herald
