早期液体复苏治疗老年重症急性胰腺炎临床研究

目的提高老年重症急性胰腺炎早期液体复苏治疗的水平。方法2009年8月至2010年8月收治老年（60岁以上）重症急性胰腺炎患者共72例，将患者分为治疗组（36例）和对照组（36例）。对治疗组患者采用快速液体复苏治疗，比较两组患者治疗效果。结果经过1周治疗，治疗组APACHEⅡ评分为（12．63±5．4），Ranson评分为（1．5±0．7）；对照组APACHEⅡ评分为（7．4±1，8），Ranson评分为（2．4±0．7），两组比较差异有统计学意义（P〈0．05）。患者平均住院时间治疗组为（22．3±3）d，对照组为（27．4±4）d，两组比较差异有统计学意义（P〈0．05）；而患者平均花费治疗组为43234．45元，对照组为44235．32元，两组比较差异无统计学意义（P〉0．05）。结论早期液体复苏治疗有利于老年重症急性胰腺炎患者改善和稳定微循环，在疾病治疗过程中起着重要的作用。

Clinical experience with early fluid resuscitation in elderly patients with severe acute pancreatitis

Objective To investigate the clinical experience with early fluid resuscitation in elderly patients with severe acute pancreatitis （SAP）. Methods Seventy - two elderly patients （ 〉 60 years old） with SAP admitted from Aug. 2009 to Aug. 2010 were divided into treatment group（ n = 36） and control group （n = 36 ）. The treatment group was subjected to early fluid resuscitation. The curative effect of the two groups were compared. Results After managment for a week, in the treatment group, APACHE II score was 12.63 ± 5.4 and Ranson score was I. 5 ± 0.7; In control group, APACHE Ⅱ was 7.4 ± 1.8 and Ranson score was 2.4± 0.7 （ P 〈 0.05 ）. Average hospitalization time in treatment group was （ 22.3 ± 3 ） d, and was （ 27.4 ± 4 ） d in control group （ P 〈 0.05 ）. Average payout in treatment group was 43234.45 yuan, and in control group was 44235.32 yuan. Conclusion The early fluid resuscitation improves the mierocirculation,which plays an important role in treatment of elderly SAP patients.