动态监测下目标导向的液体复苏在急性胰腺炎患者中的应用OA

Objective:To explore the therapeutic efficacy of goal-directed fluid resuscitation under dynamic monitoring in patients with acute pancreatitis.Method:A total of 116 patients with acute pancreatitis admitted to the Department of Gastroenterology,the Third Medical Center,Chinese PLA General Hospital from February 2023 to December 2024 were selected and divided into the experimental group and the control group according to the order of admission,with 58 cases in each group.The control group was treated with rapid fluid resuscitation,while the experimental group was treated with goal-directed fluid resuscitation under dynamic monitoring.The clinical monitoring indicators,the effective rate of fluid resuscitation,laboratory indicators,the inner diameter of the inferior vena cava and the respiratory variability of the inferior vena cava were compared between the two groups.Result:After 6 hours of intervention,the heart rate and haematocrit in the experimental group were significantly lower than those in the control group,while the central venous pressure,mean arterial pressure,urine output and fluid resuscitation volume were significantly higher than those in the control group(P<0.05).After 24 hours of intervention,the mean arterial pressure,urine output and fluid resuscitation volume in the experimental group were significantly higher than those in the control group(P<0.05).After 72 hours of intervention,there were no statistically significant differences in each clinical monitoring indicators between the two groups(P>0.05).Before the intervention,there were no statistically significant differences in laboratory indicators,the inner diameter of the inferior vena cava,and the respiratory variability of the inferior vena cava between the two groups(P>0.05).One week after the intervention,the levels of serum amylase,interleukin-6 and C reactive protein in the experimental group were lower than those in the control group(P<0.05).After 4 and 12 hours of intervention,the maximum inner diameter of the inferior vena cava in the experimental group was higher than that in the control group,and the respiratory variability of the inferior vena cava in the experimental group was lower than that in the control group(P<0.05).After 24 hours of intervention,there were no statistically significant differences in the maximum and minimum inner diameters of the inferior vena cava and the respiratory variability of the inferior vena cava between the two groups(P>0.05).One week after intervention,the effective rate of fluid resuscitation in the experimental group was higher than that in the control group(P<0.05).Conclusion:The goal-directed fluid resuscitation under dynamic monitoring can effectively improve tissue perfusion in patients with acute pancreatitis,reduce the level of inflammation,improve the inner diameter of the inferior vena cava and the respiratory variability of the inferior vena cava,increase the effective rate of resuscitation.