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目的探讨小剂量利尿剂在中-重度胰腺炎治疗中的作用。方法回顾性分析2012年1月-2013年8月62例中-重度胰腺炎患者病历资料。入院后立即给予积极液体复苏及综合治疗,使24 h尿量达到1 000 m L以上,有46例患者在24~48 h内出现呼吸>24次/min,心率>100次/min。根据患者是否使用利尿剂分为2组,对照组22例患者给予限制液体量和滴速,利尿剂组24例患者在上述方案基础上同时给予小剂量利尿剂,并统计分析两组患者的出入量、治愈率、并发症、住院周期。结果两组平均24 h入量为利尿剂组(1 076.67±88.99)m L、对照组(1 140.45±133.75)m L,差异无统计学意义(P>0.05);平均24 h尿量为利尿剂组(1 219.17±242.05)m L、对照组(1 038.18±171.54)m L,差异有统计学意义(P<0.05)。利尿剂组24例患者短期内心率、呼吸恢复正常,其局部并发症发生率为4.2%,全身并发症的发生率为12.5%,治愈好转率为91.7%,平均住院时间为(13.88±3.79)d;22例对照组患者其局部并发症发生率为27.3%,全身并发症的发生率为40.9%,治愈好转率为63.9%,平均住院时间为(19.09±4.68)d;除局部并发症发生率差异无统计学意义(P>0.05),其余指标组间差异均有统计学意义(P<0.05)。结论小剂量利尿剂在中-重度胰腺炎治疗中能有效地减少并发症发生,提高疗效,缩短住院周期。
Objective To investigate the role of low-dose diuretics in the treatment of moderate-severe pancreatitis. Methods The clinical data of 62 patients with moderate-severe pancreatitis from January 2012 to August 2013 were retrospectively analyzed. Positive fluid resuscitation and comprehensive treatment were given immediately after admission so that the urine output of 24 h reached more than 1 000 m L, and 46 patients showed respiration> 24 beats / min within 24-48 h and heart rate> 100 beats / min. According to whether patients were using diuretics were divided into two groups, 22 patients in the control group to limit the liquid volume and drip rate, 24 patients in the diuretic group on the basis of the above programs also given low-dose diuretics, and statistical analysis of two groups of patients Volume, cure rate, complications, hospitalization cycle Results The average 24-h intake of the two groups was (1 076.67 ± 88.99) m L, while the control group (1 140.45 ± 133.75) m L, with no significant difference (P> 0.05) (1 219.17 ± 242.05) m L, and control group (1 038.18 ± 171.54) m L, the difference was statistically significant (P <0.05). In the diuretic group, 24 patients had normal heart rate and respiration in a short period, with a local complication rate of 4.2%, a systemic complication rate of 12.5%, a healing improvement rate of 91.7% and an average length of hospital stay of (13.88 ± 3.79) d. The incidence of local complications was 27.3% in 22 patients in the control group, the incidence of systemic complications was 40.9%, the cure-up rate was 63.9% and the average length of hospital stay was (19.09 ± 4.68) days. There was no significant difference in the rates between the two groups (P> 0.05). The differences among the other indexes were statistically significant (P <0.05). Conclusion Low-dose diuretics in the treatment of moderate-severe pancreatitis can effectively reduce the incidence of complications, improve efficacy and shorten the hospitalization cycle.