脉搏轮廓连续心排量监测指导下的液体复苏联合肠内营养在重症急性胰腺炎中的应用研究

目的 探讨脉搏轮廓连续心排量监测(PiCCO)指导下的液体复苏联合肠内营养治疗重症急性胰腺炎(SAP)的临床价值.方法 选择2015年6月至2019年6月SAP患者120例,按照是否进行肠内营养分为观察组和对照组各60例.对照组进行PiCCO指导下的液体复苏,观察组在此基础上联用肠内营养,检测干预前后评估营养状况和炎症...

Application of PiCCO-guided fluid resuscitation combined with enteral nutrition in severe acute pancreatitis

Objective To explore the clinical significance of pulse contour cardiac output(PiCCO)guided fluid resuscitation combined with enteral nutrition in the treatment of severe pancreatitis(SAP).Methods A total of 120 SAP patients treated in our hospital from June 2015 to June 2019 were divided into observation and control groups according to whether to take enteral nutrition,60 in each group.The control group underwent fluid resuscitation under the guidance of PiCCO.The observation group combined with enteral nutrition on the basis of the control group.The nutritional status and changes in inflammatory factors were evaluated before and after the intervention.The symptom relief,complication rate and prognosis of the two groups were observed.Results The temperature recovery time,bloating relief time,first bowel movement time,blood and urine amylase recovery time,hospital stay,and APACHE II score of the observation group were significantly shorter or lower than those of the control group(P<0.05).After intervention,ALB and TP were significantly increased while serum amylase,WBC,CRP,IL-10 and TNF-αBoth were significantly reduced in both groups,and the observation group was significantly better than the control group(P<0.05).The incidence rate of complications,pseudocyst,peripancreatic infection,double infection and mortality in the observation group were significantly lower than those in the control group(P<0.05).Conclusion PiCCO-guided fluid resuscitation combined with enteral nutrition is effective in the treatment of SAP patients.It could relieve the inflammatory reactions and complications,and improve the prognosis.It has a high clinical value.