摘要
[目的]探讨不同晶胶比液体早期复苏应用在老年重症胰腺炎患者的效果和体内B型尿钠肽(BNP)浓度变化,指导临床补液。[方法]88例在我院治疗的老年重症急性胰腺炎患者病历资料进行回顾性分析,以晶胶比3:1作为分界,分为低晶胶比组和高晶胶比组,分析2组患者复苏液体用量情况以及2组患者复苏前后BNP浓度变化。[结果]低晶胶比组患者24h晶体液量(2188.75±314.78)ml,24h胶体液量(1441.23±178.66)ml,24h晶胶比值(1.37±0.18),72h输液总量(9456.28±987.64)ml,24h第3间隙液体潴留量(1854.21±243.96)ml;高晶胶比组患者24h晶体液量(3544.11±687.38)ml,24h胶体液量(924.65±113.89)ml,24h晶胶比值(3.72±0.36),72h输液总量(12231.37±1231.95)ml,24h第3间隙液体潴留量(2315.64±379.68)ml,差异有统计学意义(t=11.8917、16.1729、38.7290、11.6582、6.7821,P<0.05)。低晶胶比组患者复苏后1dBNP浓度(411.37±32.18)pg/L,复苏后2dBNP浓度(580.13±18.96)pg/L,复苏后3dBNP浓度(623.19±30.06)pg/L,出院前BNP浓度(188.74±21.55)pg/L;高晶胶比组患者复苏后1dBNP浓度(683.84±48.96)pg/L,复苏后2dBNP浓度(817.36±39.78)pg/L,复苏后3dBNP浓度(876.94±64.29)pg/L,出院前BNP浓度(498.71±48.68)pg/L,差异有统计学意义(t=30.8483、35.7091、23.7167、38.6220,P<0.05)。[结论]血浆BNP是评估重症急性胰腺炎患者补液量的重要指标之一,临床应结合患者对液体复苏的敏感程度、耐受程度等进行综合判断,及时调整液体输注速度和输液量,让患者能够平稳度过急性反应期。
[Objective]To investigate the effects of different ratios of crystalloid-colloid in early fluid resuscitation stage on elderly patients with severe acute pancreatitis and the changes of the concentration of B-type natriuretic peptide,to guide clinical rehydration.[Methods]Eighty-eight cases of elderly patients with severe acute pancreatitis in our hospital were analysed retrospectively by reviewing the medical records.With crystal gel ratio 3：1as a dividing line,low ratio group and high ratio group were selected to analyze the dosage of resuscitation fluids and the changes of BNP concentration before and after the two groups of patients＇ recovery.[Results]In the low ratio group of patients 24 hliquid crystal amount was2188.75±314.78 ml,24hcolloid fluid amount 1441.23±178.66 ml,24hcrystalloid-colloid ratio 1.37±0.18,total 72 hinfusion 9456.28±987.64 ml,24hinterstitial fluid retention amount 1854.21±243.96 ml.In the high ratio group,24 hliquid crystal amount was 3544.11±687.38 ml,24 hcolloid fluid amount924.65±113.89 ml,24hcrystalloid-colloid ratio 3.72±0.36,total 72 hinfusion 12231.37±1231.95 ml,24hinterstitial fluid retention amount 2315.64±379.68 ml.The difference between the two groups was statistically significant（t=11.8917,16.1729,38.7290,16.1729,38.7290,P〈0.05）.BNP concentration of1 dafter recovery in the low ratio group and the high ratio group was 411.37±32.18pg/L and 683.84±48.96pg/L respectively,2dafter recovery 580.13±18.96pg/L and 817.36±39.78）pg/L respectively,BNP concentration of 3dafter recovery 623.19±30.06pg/L and 876.94±64.29pg/L,BNP concentration before discharge was 188.74±21.55pg/L and 498.71±48.68pg/L respectively.The difference between the toe groups was statistically significant（t=30.8483,35.7091,23.7167,35.7091,P〈0.05）.[Conclusion]Plasma BNP was one of the important indicators to evaluate the rehydration quantity of patients with severe acute pancreatitis.Doctors should make a comprehensive judgement according to the sensitive and tolerance of patients f
出处
《中国中西医结合消化杂志》
CAS
2016年第1期44-47,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
关键词
晶胶比
液体复苏
重症急性胰腺炎
B型尿钠肽
Crystalloid-colloid ratio
Fluid resuscitation
Severe acute pancreatitis
B-type natriuretic peptide
