Early Efficacy of Different Fluid Resuscitation Methods on Severe Acute Pancreatitis and Its Influence on Intra-Abdominal Pressure and Intestinal Dysfunction of Patients
CHEN Meng'e, MO Cuiyi, et al
Qionghai People's Hospital, Hainan Qiongha 571400, China
Abstract：Objective: To explore the efficacy of different fluid selections on early fluid resuscitation of severe acute pancreatitis (SAP) as well as the influence on intra-abdominal pressure and intestinal dysfunction of patients. Methods: The various clinical data of 154 patients with severe pancreatitis admitted to the hospital between January 2018 and December 2020 were retrospectively analyzed. Different fluid resuscitation methods were used as the basis for grouping. The patients with Lactated Ringers solution (LR) were set as monotherapy group (n=74), and the patients with LR+6% hydroxyethyl starch (Hetastarch, HES) were selected as combination group (n=80). The continuous blood purification (CBP) time, mechanical ventilation time, wake-up time, biochemical indicators, intra-abdominal pressure and intestinal function were compared between the two groups. Results: ① Comparison of recovery showed that the CBP time and mechanical ventilation time of combination group were shorter than those of monotherapy group, and the wake-up time of combination group was earlier(P<0.05). ② At different time points, there was a statistically significant difference in the intra-abdominal pressure (IAP) between the two groups, with time-point effect (P<0.01). ③ In terms of interleukin 10 (IL-10), white blood cells (WBC), blood urine amylase (AMS) and serum lipase (LPS), the increase of IL-10 after intervention in the combination group was greater than that in the monotherapy group, and the decrease of WBC, AMS and LPS of the combination group were greater (P<0.05). ④ As for intestinal dysfunction, the incidence rates of abdominal pain, constipation, abdominal distension and abdominal tenderness in combination group after intervention were lower compared with that in monotherapy group (P<0.05). ⑤ The 90.00% effective rate of resuscitation in combination group was higher than 81.08% in monotherapy group after intervention (χ2=2.497; P=0.114>0.05). Conclusion: In the early fluid resuscitation of patients with SAP, LR+6% Hetastarch has a better efficacy. It can promote the resuscitation, reduce the intra-abdominal pressure and intestinal dysfunction, maintain the plasma colloidal osmotic pressure, and keep the acid-base balance, thus it is suitable for clinical promotion.
陈孟娥, 莫翠毅, 蔡曼妮, 邱坚. 不同液体复苏方式对重症急性胰腺炎早期临床疗效及对患者腹内压和肠道功能障碍的影响[J]. 河北医学, 2022, 28(3): 441-445.
CHEN Meng'e, MO Cuiyi, et al. Early Efficacy of Different Fluid Resuscitation Methods on Severe Acute Pancreatitis and Its Influence on Intra-Abdominal Pressure and Intestinal Dysfunction of Patients. HeBei Med, 2022, 28(3): 441-445.
2022, Vol. 28 
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