本文選題：重癥急性胰腺炎　切入點(diǎn)：超聲監(jiān)測　出處：《南京醫(yī)科大學(xué)學(xué)報(bào)(自然科學(xué)版)》2017年11期

【摘要】：目的:評價(jià)下腔靜脈超聲監(jiān)測下目標(biāo)導(dǎo)向液體治療(goal-directed fluid therapy,GDFT)對重癥胰腺炎患者預(yù)后的影響。方法:將重癥監(jiān)護(hù)病房(intensive care unit,ICU)收治的重癥急性胰腺炎患者120例(男82例,女38例)隨機(jī)分為兩組:A組采用下腔靜脈超聲監(jiān)測的GDFT 72 h,B組采用重癥急性胰腺炎常規(guī)液體治療72 h,比較兩組患者生命體征、血流動(dòng)力學(xué)參數(shù)和實(shí)驗(yàn)室檢查等。結(jié)果:A組和B組患者72 h復(fù)蘇液體總量分別為(14 500±920)m L、(12 500±815)m L,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.01);A組液體復(fù)蘇后下腔靜脈呼吸變異度[(19.00±4.75)%]明顯小于治療前[(60.66±10.10)%,P0.01];治療后A組腹內(nèi)壓與B組比較差異無統(tǒng)計(jì)學(xué)意義;A組的APACHEⅡ評分低于B組(P0.05);A組血乳酸、白介素6(interleukin 6,IL-6)、C-反應(yīng)蛋白較B組均低(P0.05);A組患者ICU住院日、需要手術(shù)減壓率均低于B組(P0.05)。但兩組患者ICU病死率、28 d生存率無明顯差異。結(jié)論:對重癥急性胰腺炎患者進(jìn)行下腔靜脈超聲監(jiān)測下GDFT能達(dá)到較好的液體復(fù)蘇效果,改善患者的循環(huán)狀態(tài)、減輕炎癥反應(yīng),降低腹腔內(nèi)高壓發(fā)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 鹵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 鹵4. 75% (P < 0. 01). The APACHE 鈪，

本文編號：1663962