高渗盐水用于急性胰腺炎与临床观察.docVIP

高渗盐水用于急性胰腺炎的临床观察( 朱涛，刘菊英，向勇 【摘要】 目的 .5%高渗盐水4ml/kg，B组则在同时点输复方氯化钠溶液，余治疗同，分别于术后1d、3d、5d、7d、10d、15d进行血尿淀粉酶及白细胞计数的变化；并分别于入手术时时（T0）、术后4小时（T1）、24小时（T2）、36 小时（T3）、48小时（T4）分别测定IL-6和IL-8。结果　T1时MAP、CVP A组明显高于B组（P0.05），HR组间比较无显著性差异（P0.05）；HR在T2时A组较B组低（P0.05），MAP、CVP组间比较无显著性差异（P0.05）；T3时MAP、CVP A组明显高于B组（P0.05），HR组间比较无显著性差异（P0.05）；T2、T3、T4时IL-6、IL-8 A组明显低于B组（P0.05），并且均低于T0时。血淀粉酶在术后15d内两组间无显著性差异（P0.05）；尿淀粉酶在术后1w内两组间无显著性差异（P0.05），10d、15d时A组明显低于B组（P0.05）；而WBC自3d起A组明显低于B组（P0.05）。结论　高渗盐水可降低胰腺炎围手术期间的血浆IL-6、 IL-8水平，抑制全身性炎症反应，对胰腺炎伴随的全身炎性反应有肯定治疗作用。 【关键词】 Clinical study of acute pancreatitis treated with small - volume hypertonic saline ZHU Tao*,JIANG Bin,XIANG Yong,et al.*Department of Anesthesiology,Taihe Hospital of Yunyang Medical College,Shiyan 442000,China 【Abstract】 Objective To study the effect of treatment on interleukin-6(IL-6), interleukin-8(IL-8),hemodynamics,blood and urine amylase, white blood cell (WBC) count,and prognosis in surgical patients with pancreatitis,as to explain its action mechanisms.Methods A total of 48 surgical patients suffering from critical pancreatitis were randomized to receive intravenously either 4ml.kg-1 of 7.5% hypertonic saline(n=24;group A) or compound sodium chloride(n=24;group B) at preoperation and 24h after operation.Blood and urine amylase level and WBC count were analysed at 1d、3d、5d、7d、10d、15d after operation; IL-6 and IL-8 were measured at the time of entering operating room(T0) and at 4h(T1)、24h(T2)、36h(T3)、48h(T4) after operation Results At T1,the mean arterial pressure (MAP) and central venous pressure (CVP) in group A were significantly higher than in group B（P0.05）,and the heart rate(HR) in group A did not differ from that in group B（P0.05）;at T2, HR in group A was significantly lower than in group B（P0.05）,and MAP and CVP between both groups were not different（P0.05）; at T3, MAP and CVP in group A were significantly higher than in group B（P0.05）,and HR between both groups was not different（P0.05）.At T2、T3 and T4, IL-6 and IL-8 in g