急性胰腺炎早期液体治疗的临床研究

目的探讨早期液体治疗对急性胰腺炎预后的影响。方法对我院普外科2000年1月～2006年12月150例急性胰腺炎患者，进行液体治疗后的疗效结果进行回顾性分析，按时间分为2组：2000年1月。2002年8月45例给予液体正平衡治疗为A组。2002年9月-2006年12月105例给予液体负平衡治疗为B组。2组均给予严密的肝功能、肾功能及血清电解质监测。结果2000年1月-2002年8月组40人中有12人发展成重症胰腺炎，死亡4人。另外5人为入院时已诊断为重症胰腺炎，死亡2人。2002年9月-2006年12月组98人中有13人发展成重症胰腺炎，无死亡病人。另外7人为入院时已诊断为重症胰腺炎，死亡2人。经过监测发现2种液体治疗均未对患者肝功能及肾功能造成损伤或加重损伤，且血清电解质也未出现明显异常，甚至得到合理纠正。结论对急性胰腺炎行早期液体治疗，尤其是行液体负平衡治疗能有效地预防急性胰腺炎病情进一步加重，即使对重症胰腺炎也能减少并发症，降低死亡率，改善预后。

The clinical study of early fluid therapy in acute pancreatitis.

Objective To investigate the effect of the early fluid therapy on acute pancreatitis. Methods From January 2000 to December 2006,150 cases of acute pancreatitis with liquid therapy were retrospectively analysed.All cases were divided into two groups. From January 2000 to August 2002, 45 cases were treated by positive balance of fluid. From September 2002 to December 2006,105 cases were treated by negative balance of fluid. Both groups were with strict monitoring of liver function, kidney function and serum electrolyte.Results January 2000-August 2002,12 people developed into severe pancreatitis and 2 people dead. From September 2002 to December 2006,13 patients developed into severe pancreatitis and but no deaths of patients. Another 7 cases were diagnosed as severe pancreatitis in outpatient department,two people dead. In both two groups,no patients＇ liver function or kidney function were injuryed or aggravated, and electrolyte did not abnormalize. Conclusion Early fluid therapy on acute panereatitis,especially negative balance of fluid therapy,can effectively prevent acute pancreatitis from aggravation, it can reduce complications and mortality,and improves the prognosis.