下腔静脉超声监测下目标导向液体治疗对重症急性胰腺炎患者预后的影响

发布时间：2018-03-25 16:26

  本文选题：重症急性胰腺炎　切入点：超声监测　出处：《南京医科大学学报(自然科学版)》2017年11期

【摘要】：目的:评价下腔静脉超声监测下目标导向液体治疗(goal-directed fluid therapy,GDFT)对重症胰腺炎患者预后的影响。方法:将重症监护病房(intensive care unit,ICU)收治的重症急性胰腺炎患者120例(男82例,女38例)随机分为两组:A组采用下腔静脉超声监测的GDFT 72 h,B组采用重症急性胰腺炎常规液体治疗72 h,比较两组患者生命体征、血流动力学参数和实验室检查等。结果:A组和B组患者72 h复苏液体总量分别为(14 500±920)m L、(12 500±815)m L,两组比较差异有统计学意义(P0.01);A组液体复苏后下腔静脉呼吸变异度[(19.00±4.75)%]明显小于治疗前[(60.66±10.10)%,P0.01];治疗后A组腹内压与B组比较差异无统计学意义;A组的APACHEⅡ评分低于B组(P0.05);A组血乳酸、白介素6(interleukin 6,IL-6)、C-反应蛋白较B组均低(P0.05);A组患者ICU住院日、需要手术减压率均低于B组(P0.05)。但两组患者ICU病死率、28 d生存率无明显差异。结论:对重症急性胰腺炎患者进行下腔静脉超声监测下GDFT能达到较好的液体复苏效果,改善患者的循环状态、减轻炎症反应,降低腹腔内高压发生率。
[Abstract]:Objective: to evaluate the effect of goal-directed fluid therapy (GDFTs) on the prognosis of patients with severe pancreatitis under the monitoring of inferior vena cava ultrasound (IVC). Methods: 120 patients (82 males) with severe acute pancreatitis were treated in intensive care Unit (ICU). Women (38 cases) were randomly divided into two groups: group 1: group A: GDFT 72h, Group B: routine fluid therapy of severe acute pancreatitis for 72h, and the vital signs were compared between the two groups. Results the total volume of fluid resuscitation in group A and group B was 14 500 卤9 20 min / L after 72 h resuscitation, respectively. The difference between the two groups was statistically significant (P 0. 01) after fluid resuscitation, the variance of lower vena cava respiration was 19. 00 卤4. 75% (P < 0. 01). The APACHE 鈪，

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