摘要
目的探讨早期限制性液体复苏对重症急性胰腺炎患者肠道功能复苏和肠道免疫功能的影响。方法回顾性分析江苏省中医院2012年5月至2016年12月收治的52例重症急性胰腺炎患者的临床资料,根据治疗方式的不同分为早期限制性液体复苏组(观察组,30例)和单纯液体复苏组(对照组,22例),比较两组患者的胃肠功能障碍评分、腹内压、肠道功能恢复时间、腹部体征消失时间及免疫学指标。结果两组患者治疗后胃肠功能障碍评分和腹内压较治疗前差异均有统计学意义(P均<0.05),且观察组在治疗后胃肠功能障碍评分和腹内压均显著低于对照组(P<0.05)。观察组患者在肠道功能恢复时间、腹部体征消失时间方面均优于对照组,差异有统计学意义(P<0.05)。干预前,两组患者的免疫指标差异无统计学意义(P>0.05);干预后,两组患者血清免疫球蛋白及外周血T淋巴细胞亚群水平均明显上升,且观察组显著高于对照组,差异有统计学意义(P均<0.05)。结论早期限制性液体复苏可以明显改善重症急性胰腺炎患者的胃肠功能障碍,降低腹内高压的发生率,提高机体的免疫功能,从而改善患者的预后情况。
Objective To investigate the effect of early controlled fluid resuscitation on intestinal function resuscitation and intestinal immune function in patients with severe acute pancreatitis.Methods A retrospective analysis was performed of clinical data of 52 patients with severe acute pancreatitis from May 2012 to December 2016.All patients were divided into 2 groups randomly:30 patients in observation group (early controlled fluid resuscitation)and 22 patients in control group (simple fluid resuscitation group).Gastrointestinal dysfunction score,abdominal pressure,recovery time of intestinal function,disappearance time of abdominal signs and immunological indexes in the two groups were compared.Results Both groups had a significant change in gastrointestinal dysfunction score and abdominal pressure after treatment (P<0.05), and the treatment group had a significantly lower gastrointestinal dysfunction score and abdominal pressure than those in the control group (P<0.05).After the therapy,the recovery time of intestinal function and disappearance time of abdominal signs in observation group were changed more than those in control group (P<0.05).The levels of the blood immunoglobulin and the immunologic parameters in observation group were changed more than those in control group (P<0.05). Conclusion Early controlled fluid resuscitation could significantly improve gastrointestinal dysfunction in patients with severe acute pancreatitis,reduce the incidence of intra-abdominal hypertension,and improve the body's immune function and the clinical outcome.
作者
李江利
龚冠闻
张传灼
LI Jiang-li;GONG Guan-wen;ZHANG Chuan-zhuo(Department of General Surgery,the First Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Nanfing ,Jiangsu210029,China)
出处
《热带医学杂志》
CAS
2018年第11期1451-1454,共4页
Journal of Tropical Medicine
基金
江苏省中医药局科技项目(Yb2015021)
关键词
早期限制性液体复苏
重症急性胰腺炎
肠道功能
免疫功能
Early controlled fluid resuscitation
Severe acute pancreatitis
Intestinal function
Immune function
