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目的观察静脉输注6%羟乙基淀粉130/0.4(万汶)和静脉推注呋噻米(速尿)对急性胰腺炎转归的影响。方法116例急性胰腺炎患者入院当日即给予6%羟乙基淀粉130/0.4静脉输注(成人通常为1000～2000ml),次日开始逐渐减少其用量;在输注6%羟乙基淀粉130/0.4的同时静脉推注呋噻米,力求作到出入量基本平衡。结果应用6%羟乙基淀粉和呋噻米1～3天后,血容量恢复正常;99例患者痊愈后的血细胞压积(Hct)为33.6±5.7,显著低于入院时的41.6±6.9(t=13.359,P<0.05);血浆白蛋白浓度为(33.2±7.8)g/L,与入院时(36.3±8.2)g/L比较,差异无显著性意义(t=2.019,P>0.05);局部并发症发生率仅5%,全身并发症发生率6%,胰腺手术率4%。结论静脉注射6%羟乙基淀粉130/0.4和呋噻米可改善急性胰腺炎的转归,血浆外渗是急性胰腺炎的中心事件和治疗重点。
Objective To observe the effect of intravenous infusion of 6% hydroxyethyl starch 130 / 0.4 (Van Wen) and intravenous furosemide (furosemide) on the outcome of acute pancreatitis. Methods One hundred and sixty-six patients with acute pancreatitis were given intravenous infusion of 6% hydroxyethylstarch 130 / 0.4 on day of admission (usually, 1000-2000ml for adults), and gradually decreased their dosage on the next day. After infusion of 6% hydroxyethyl starch 130 /0.4 at the same time intravenous injection furosemide, and strive to make a basic balance of access. Results Blood volume returned to normal after 1 to 3 days of application of 6% hydroxyethyl starch and furosemide. The hematocrit (Hct) of 99 patients recovered was 33.6 ± 5.7, which was significantly lower than that of admission 41.6 ± 6.9 (t = 13.359, P <0.05). The serum albumin concentration was (33.2 ± 7.8) g / L, there was no significant difference between the two groups (t = 2.019, P> 0.05) The incidence of local complications was only 5%, the incidence of systemic complications 6%, 4% of pancreatic surgery. Conclusion Intravenous injection of 6% hydroxyethyl starch 130 / 0.4 and furosemide can improve the outcome of acute pancreatitis. Plasma extravasation is the central event and focus of treatment for acute pancreatitis.