急性胰腺炎患者液体疗法的并发症:贡献

C. Henriques, J. Pereira, A. Matos, C. Afonso
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摘要

简介:积极的液体疗法经常被建议用于治疗急性胰腺炎。然而,关于这种疗法的临床并发症的发展和是否需要手术,存在一些争议。目的:探讨术后48小时内液体给药与局部或全身并发症发生的关系,有助于澄清这方面的一些开放性问题。方法:本研究基于2007年至2012年间在Tondela Viseu医院中心外科高依赖病房就诊的109例诊断为急性胰腺炎的患者的记录。研究了数据,并使用统计检验来识别区分并发症患者的变量。受试者工作特征(ROC)曲线可以将48小时内的液体量与每种并发症的发生联系起来。采用Logistic回归模型确定各并发症的独立危险因素。结果:48小时液体治疗与死亡及全身并发症的发生无明显关系。相反,48小时液体治疗显示与局部和晚期并发症、感染的存在和需要手术有关。结论:术后48小时内高剂量液体治疗与并发症的发生有关。
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Complications of fluidotherapy in patients with acute pancreatitis: A contribution
Introduction: Aggressive fluid therapy is frequently suggested in the treatment of acute pancreatitis. However, there is some controversy about the effect of this therapy concerning the development of clinical complications and the need for surgery. Objectives: To explore the relationship between fluid administration in the first 48 hours and the development of local or systemic complications, to contribute to clarifying some open questions on this subject. Methods: This study is based on records of 109 patients admitted to the Surgical High Dependency Unit of Tondela Viseu Hospital Centre, between 2007 and 2012, with the diagnosis of acute pancreatitis. Data were explored, and statistical tests were used to identify variables that differentiate patients with complications. Receiver operating characteristic (ROC) curves allowed to relate the amount of fluids at 48 hours with the occurrence of each complication. Logistic regression models were used to identify independent risk factors for each complication. Results: There was no significant relationship between fluid therapy at 48 hours with death nor with the occurrence of systemic complications. As opposed, fluid therapy at 48 hours revealed to be associated with local and late complications, presence of infection and need for surgery. Conclusion: High levels of fluid therapy in the first 48 hours were associated with the development of complications.
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