摘要
目的 探讨乳酸钠林格注射液在急性胰腺炎早期液体复苏中的应用价值.方法 回顾性分析2021年6月至2023年6月期间合肥市第二人民医院收治的182例急性胰腺炎(AP)的患者,并根据早期补液方法分为乳酸钠林格注射液组(LRS)组和生理盐水溶液(NSS)组.分析统计两组一般临床资料、局部并发症、器官衰竭病人数以及入院治疗后48小时的CRP水平、pH和HCO3水平等资料.结果 两组患者在年龄、性别、基础疾病史、APACHE Ⅱ评分、Ranson评分、病因、入院时CRP方面没有显著差异,NSS组局部并发症和器官衰竭发生率均高于LRS组,但两组比较差异无统计学意义(P＞0.05).在AP严重程度方面,LRS组出现中度AP的频率显著低于NSS组(P=0.015).两组住院时间差异无统计学意义.两组CRP水平在48小时内均有所升高,然而LRS组早期液体复苏治疗后与NSS组相比,LRS组的患者在第48小时的CRP水平较低(P=0.012).尽管复苏48小时后两组患者的pH和HCO3水平变化在正常范围内,但与NSS组复苏患者相比,LRS患者的pH和HCO3水平变化有利于代谢性酸中毒(P=0.022).结论 LRS对AP的严重程度有积极的影响,并具有抗炎作用.
Abstract
Objectives To investigate the application value of Lactated Ringer's solution in early fluid resuscitation of acute pan-creatitis.Methods A retrospective analysis was performed on 182 patients with acute pancreatitis admitted to the Second People's Hos-pital of Hefei City from June 2021 to June 2023,and they were divided into Lactated Ringer's solution group(LRS)and normal saline solution(NSS)group according to early fluid rehydration method.The general clinical data,local complications,organ failure,CRP levels,pH and HCO3 levels 48 hours after admission were analyzed and analyzed.Results There were no significant differences be-tween the two groups in age,gender,underlying disease history,APACHEII score,Ranson score,etiology,and CRP on admission.The incidence of local complications and organ failure in NSS group was higher than that in LRS group,but there was no statistically significant difference between the two groups(P＞0.05).In terms of AP severity,the frequency of moderate AP was significantly lower in the LRS group than in the NSS group(P=0.015).There was no significant difference in length of stay between the two groups.CRP levels were elevated in both groups at 48 hours,however,patients in the LRS group had lower CRP levels at 48 hours after early fluid resuscitation compared with those in the NSS group(P=0.012).Although changes in pH and HCO3 levels were within the normal range in both groups 48 hours after resuscitation,changes in pH and HCO3 levels in LRS patients favored metabolic acidosis compared with resuscitation patients in the NSS group(P=0.022).Conclusion LRS has a positive effect on the severity of AP and has an anti-inflammatory effect.
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