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目的探讨新鲜冰冻血浆强化的早期目标导向液体复苏(early goal-directed fluid therapy,EGDT)方案对重症急性胰腺炎(severe acute pancreatitis,SAP)的疗效。方法 2010年1月至2014年6月,按照连续采样的方法收集我科就诊的重症急性胰腺炎患者79例,所有患者随机分为接受一般液体复苏治疗的对照组(A组,27例),早期目标导向液体复苏治疗的试验1组(B组,30例)和新鲜冰冻血浆强化的早期目标导向液体复苏治疗的试验2组(C组,22例)。组间患者一般情况构成差异无统计学意义。比较组间患者ICU入住时间,腹腔间隔室综合征(abdominal compartment syndrome,ACS)、MODS发生率以及住院死亡率的差异。结果与A组相比,B、C组患者1CU入住时间较短,ACS、MODS发生率及病死率较低,组间差异有统计学意义(P<0.05);与B组相比,C组患者ICU入住时间较短,ACS、MODS发生率及病死率较低,组间差异有统计学意义(P<0.05)。结论新鲜冰冻血浆强化的EGDT方案有助于缩短SAP患者ICU入住时间,降低ACS、MODS发生率及病死率。
Objective To investigate the effect of fresh frozen plasma-enhanced early goal-directed fluid therapy (EGDT) on patients with severe acute pancreatitis (SAP). Methods From January 2010 to June 2014, 79 patients with severe acute pancreatitis treated in our department were collected according to the continuous sampling method. All patients were randomly divided into control group (group A, n = 27) receiving general fluid resuscitation, Group 1 (group B, n = 30) and group 2 (group C, n = 22) treated with early-targeted fluid-resuscitation therapy and fresh-frozen plasma-enhanced early target-directed fluid resuscitation. There was no significant difference in the general situation of patients between groups. The ICU admission time, abdominal compartment syndrome (ACS), incidence of MODS and in-hospital mortality were compared between groups. Results Compared with group A, patients in group B and C had shorter stay of admission, lower incidence of ACS and MODS, and lower mortality rate (P <0.05). Compared with group B, group C ICU patients admitted to a shorter time, ACS, MODS incidence and mortality were lower, the difference between the two groups was statistically significant (P <0.05). Conclusion Fresh and frozen plasma enhanced EGDT regimen can shorten the ICU admission time and reduce the incidence of ACS and MODS and mortality in patients with SAP.