Background Fluid therapy for severe acute pancreatitis （SAP） should not only resolve deficiency of blood volume, but also prevent fluid sequestration in acute response stage. Up to date, there has not a strategy for...Background Fluid therapy for severe acute pancreatitis （SAP） should not only resolve deficiency of blood volume, but also prevent fluid sequestration in acute response stage. Up to date, there has not a strategy for fluid therapy dedicated to SAP. So, this study was aimed to investigate the effects of fluid therapy treatment on prognosis of SAP. Methods Seventy-six patients were admitted prospectively according to the criteria within 72 hours of SAP onset. They were randomly assigned to a rapid fluid expansion group （Group I, n=36） and a controlled fluid expansion group （Group II n=-40）. Hemodynamic disorders were either quickly （fluid infusion rate was 10-15 ml.kg-1-h-1, Group I） or gradually improved （fluid infusion rate was 5-10 ml-kg1.h-1, Group II） through controlling the rate of fluid infusion. Parameters of fluid expansion, blood lactate concentration were obtained when meeting the criteria for fluid expansion. And APACHE II scores were obtained serially for 72 hours. Rate of mechanical ventilation, incidence of abdominal compartment syndrome （ACS）, sepsis, and survival rate were obtained. Results The two groups had statistically different （P 〈0.05） time intervals to meet fluid expansion criteria （Group I, 13.5±6.6 hours; Group II, （24.0±5.4） hours）. Blood lactate concentrations were both remarkably lower as compared to the level upon admission （P 〈0.05） and reached the normal level in both groups upon treatment. It was only at day 1 that hematocrit was significantly lower in Group I （35.6%±6.8%） than in Group II （38.5%±5.4%） （P〈0.01）. Amount of crystalloid and colloid in group I （（4028±1980）ml and （1336±816）ml） on admission day was more than those of group II （（2472±1871）ml and （970±633）ml）. No significant difference was found in the total amount of fluids within four days of admission between the two groups （P〉0.05）. Total amount of fluid sequestration within 4 days was higher in Group I （（5378±2751）ml�展开更多
目的:探讨慢性阻塞性肺疾病(COPD)急性加重期常见证候及其特征。方法:收集4所三甲医院COPD急性加重期患者资料,使用Epidata软件建立数据库,运用SPSS 13.0 for windows统计软件包进行频次和频率的统计描述及Logistic回归方法分析。结果:1...目的:探讨慢性阻塞性肺疾病(COPD)急性加重期常见证候及其特征。方法:收集4所三甲医院COPD急性加重期患者资料,使用Epidata软件建立数据库,运用SPSS 13.0 for windows统计软件包进行频次和频率的统计描述及Logistic回归方法分析。结果:1046例患者中出现了28个证候,其中频率与构成比最高的证候是痰热壅肺证,分别为60.23%、8.77%,其次是肺气虚证,分别为46.18%、6.73%。COPD急性加重期常见证候有痰热壅肺证、外寒内饮证、痰湿阻肺证、痰瘀阻肺证、肺脾气虚证、肺肾气虚证、肺肾阴虚证、肺肾气阴两虚证,并对其主次症特征作了分析。结论:COPD急性加重期常见证候有8种,其中痰热壅肺证是最常见的一种。展开更多
文摘Background Fluid therapy for severe acute pancreatitis （SAP） should not only resolve deficiency of blood volume, but also prevent fluid sequestration in acute response stage. Up to date, there has not a strategy for fluid therapy dedicated to SAP. So, this study was aimed to investigate the effects of fluid therapy treatment on prognosis of SAP. Methods Seventy-six patients were admitted prospectively according to the criteria within 72 hours of SAP onset. They were randomly assigned to a rapid fluid expansion group （Group I, n=36） and a controlled fluid expansion group （Group II n=-40）. Hemodynamic disorders were either quickly （fluid infusion rate was 10-15 ml.kg-1-h-1, Group I） or gradually improved （fluid infusion rate was 5-10 ml-kg1.h-1, Group II） through controlling the rate of fluid infusion. Parameters of fluid expansion, blood lactate concentration were obtained when meeting the criteria for fluid expansion. And APACHE II scores were obtained serially for 72 hours. Rate of mechanical ventilation, incidence of abdominal compartment syndrome （ACS）, sepsis, and survival rate were obtained. Results The two groups had statistically different （P 〈0.05） time intervals to meet fluid expansion criteria （Group I, 13.5±6.6 hours; Group II, （24.0±5.4） hours）. Blood lactate concentrations were both remarkably lower as compared to the level upon admission （P 〈0.05） and reached the normal level in both groups upon treatment. It was only at day 1 that hematocrit was significantly lower in Group I （35.6%±6.8%） than in Group II （38.5%±5.4%） （P〈0.01）. Amount of crystalloid and colloid in group I （（4028±1980）ml and （1336±816）ml） on admission day was more than those of group II （（2472±1871）ml and （970±633）ml）. No significant difference was found in the total amount of fluids within four days of admission between the two groups （P〉0.05）. Total amount of fluid sequestration within 4 days was higher in Group I （（5378±2751）ml�
文摘目的:探讨慢性阻塞性肺疾病(COPD)急性加重期常见证候及其特征。方法:收集4所三甲医院COPD急性加重期患者资料,使用Epidata软件建立数据库,运用SPSS 13.0 for windows统计软件包进行频次和频率的统计描述及Logistic回归方法分析。结果:1046例患者中出现了28个证候,其中频率与构成比最高的证候是痰热壅肺证,分别为60.23%、8.77%,其次是肺气虚证,分别为46.18%、6.73%。COPD急性加重期常见证候有痰热壅肺证、外寒内饮证、痰湿阻肺证、痰瘀阻肺证、肺脾气虚证、肺肾气虚证、肺肾阴虚证、肺肾气阴两虚证,并对其主次症特征作了分析。结论:COPD急性加重期常见证候有8种,其中痰热壅肺证是最常见的一种。
