早期集束化治疗对急性重症胰腺炎并发脓毒症休克患者预后的影响

目的:观察早期集束化治疗对于急性重症胰腺炎并发脓毒症休克患者预后的影响.方法:63例急性重症胰腺炎并发脓毒症休克患者分为2组,所有患者进行生命体征监测,并且均在入院72h内进行手术治疗,后返回重症监护室进行加强治疗.A组(n=31)进行一般性抗感染和补液升压治疗,维持血压在90/60mmHg以上;B组(n=32)进行集束化治疗.1h内给予抗生素治疗;补液20mL/kg;维持平均动脉压≥65mmHg,中心静脉压≥8mmHg,控制血糖8.3mmol/L内,应用甲强龙、机械通气等.观察抗休克治疗24h的疗效和1mo内死亡率.结果:两组患者在性别、年龄、APACHEII评分方面没有统计学差异(P>0.05),具有可比性.A组患者抗休克治疗有效率38.71%(12/31),死亡率70.97%(22/31),B组患者抗休克治疗有效率68.75%(22/32),死亡率43.75%(14/32,P<0.05).结论:早期集束化治疗可以改善急性重症胰腺炎并发脓毒症休克患者预后.

Early bundle therapy improves the prognosis of patients with severe acute pancreatitis and septic shock

AIM: To evaluate the influence of early bundle therapy on the prognosis of patients with severe acute pancreatitis and septic shock. METHODS: A total of 63 patients with severe acute pancreatitis and septic shock were included in the study. The vital signs of all patients were monitored continuously, and all patients were given operational treatment within 72 hours of admission. These cases were divided into two groups: group A (n = 31) was treated with anti-infection and fluid infusion to elevate blood pressure, and group B (n = 32) underwent early bundle therapy. The curative effect of antishock therapy within 24 hours and mortality within one month were observed.RESULTS: The curative effect of anti-shock within 24 hours was significantly lower in group A than in group B (38.71% vs 68.75%, P = 0.017), and the mortality within one month was significantly higher in group A than in group B (70.97% vs 43.75%, P = 0.029). CONCLUSION: Early bundle therapy can improve prognosis and reduce mortality in patients with severe acute pancreatitis and septic shock.