The clinical value of early hypertonic saline fluid resuscitation for patients with acute pancreatitis

目的：探讨早期高渗盐水液体复苏治疗急性胰腺炎的临床价值。方法选择2012年12月至2014年5月期间收治的90例急性胰腺炎患者，将所有患者随机分成高渗盐水液体复苏组（观察组）和林格液液体复苏组（对照组），各45例。对两组患者的炎症反应指标、肠黏膜屏障功能、并发症及预后指标进行分析。结果与对照组相比，观察组患者治疗后白细胞计数（WBC）、C 反应蛋白（CRP）、肿瘤坏死因子（TNF -α）、白细胞介素6（IL -6）及 IL -8降低更明显，差异有统计学意义（ P <0.05）。对两组患者的肠黏膜屏障功能进行分析，与对照组相比，观察组患者治疗后在D -乳酸、L/ M 升高更明显，差异有统计学意义（ P <0.05）。且观察组患者 APCHEII 评分、机械通气率、心功能不全、多脏器功能障碍综合征（MODS）、腹内压、腹腔间隔综合征及病死率明显低于对照组，差异有统计学意义（ P <0.05）。结论高渗盐水对急性胰腺炎患者的治疗效果良好，可明显改善其体内炎症反应和肠黏膜屏障方面功能，降低并发症发生率，从而达到改善临床预后的目的。Objective To study the clinical value of early hypertonic saline fluid resuscitation for patients with acute pancreatitis. Meth-ods 90 cases of patients with acute pancreatitis were treated in Peking University Shenzhen Hospital from December 2012 to May 2014. All pa-tients were randomly divided into hypertonic saline fluid resuscitation group(observation group)and Ringer′s fluid resuscitation group( control group). All 45 cases indicators of the two groups of patients,including intestinal barrier function,complications and prognosis indicators were ana-lyzed and compared. Results Compared with the control group,white blood cell count(WBC),C - reactive protein(CRP),tumor necrosis fac-tor(TNF - α),interleukin - 6(IL - 6)and IL - 8 of the observation group patients was significantly more reduced,the difference was statistical-ly significant( P < 0. 05). Intestinal barrier function of the two groups of patients were analyzed. Compared with the control group,D - lactic acid,L/ M in patients of the observation group increased more significantly,the difference was statistically significant( P < 0. 05). And the AP-CHEII score,ventilation rate,heart failure,MODS,intra - abdominal pressure,abdominal compartment syndrome and mortality of the observation group was significantly lower than the control group,the difference was statistically significant( P < 0. 05). Conclusion Hypertonic saline treat-ment of patients with acute pancreatitis had good result. This method can significantly improve the body inflammation and intestinal mucosal barrier function aspects,reduce the incidence of complications,so as to achieve the purpose of improving clinical outcomes.中国科技核心期刊(ISTIC)8777-779,7801