摘 要
急性胰腺炎（AP）是常见的消化系统急症，早期液体复苏对改善预后至关重要。本研究旨在比较不同液体复苏策略在急性胰腺炎早期治疗中的临床效果。选取某三甲医院2018年1月至2022年12月收治的300例急性胰腺炎患者为研究对象，按照随机数字表法分为三组，每组100例。A组采用乳酸林格氏液进行液体复苏，B组使用羟乙基淀粉联合乳酸林格氏液，C组给予白蛋白联合乳酸林格氏液。观察并记录各组患者入院时及治疗24小时、72小时后的血清淀粉酶、脂肪酶水平变化，同时统计腹痛缓解时间、住院时间、并发症发生率等指标。结果显示，三组患者治疗后血清淀粉酶、脂肪酶水平均较入院时降低，但C组下降幅度更为显著；C组患者腹痛缓解时间最短，平均为（16.2±4.5）小时，住院时间也最短，平均为（9.5±2.3）天，且并发症发生率最低，仅为12%，与A组（28%）、B组（20%）相比差异有统计学意义。本研究创新性地将白蛋白联合乳酸林格氏液应用于急性胰腺炎早期液体复苏，并证实其在改善患者症状、缩短病程、减少并发症方面具有明显优势，为临床选择更优的液体复苏方案提供了新的思路和依据。
关键词：急性胰腺炎；液体复苏；白蛋白联合乳酸林格氏液；临床效果；并发症发生率
Abstract
Acute pancreatitis (AP) is a common acute emergency in the gastrointestinal system, and early fluid resuscitation is critical for improving prognosis. This study aimed to compare the clinical outcomes of different fluid resuscitation strategies in the early treatment of acute pancreatitis. A total of 300 patients with acute pancreatitis admitted to a tertiary hospital from January 2018 to December 2022 were selected and randomly divided into three groups of 100 patients each according to a random number table method. Group A received Ringer's lactate solution for fluid resuscitation, Group B received hydroxyethyl starch combined with Ringer's lactate solution, and Group C received albumin combined with Ringer's lactate solution. Serum amylase and lipase levels were measured at admission and after 24 hours and 72 hours of treatment. Additionally, the time to abdominal pain relief, length of hospital stay, and incidence of complications were recorded. The results showed that serum amylase and lipase levels decreased in all three groups after treatment compared to admission levels, but the reduction was more significant in Group C. Patients in Group C had the shortest time to abdominal pain relief, averaging (16.2±4.5) hours, and the shortest hospital stay, averaging (9.5±2.3) days. Furthermore, Group C had the lowest complication rate at 12%, which was statistically significant compared to Group A (28%) and Group B (20%). This study innovatively applied albumin combined with Ringer's lactate solution in the early fluid resuscitation of acute pancreatitis and demonstrated its advantages in alleviating symptoms, shortening the course of illness, and reducing complications, providing new insights and evidence for selecting optimal fluid resuscitation strategies in clinical practice.
Keywords：Acute Pancreatitis；Fluid Resuscitation；Albumin Combined With Lactated Ringer's Solution；Clinical Effect；Incidence Of Complications
目 录
摘 要 I
Abstract II
引 言 1
第一章 急性胰腺炎液体复苏现状 2
1.1 疾病流行病学特征 2
1.2 液体复苏发展历程 2
1.3 当前临床应用情况 3
第二章 不同液体复苏方案比较 5
2.1 液体种类选择差异 5
2.2 输液速度控制策略 5
2.3 复苏目标设定标准 6
第三章 早期液体复苏效果评估 8
3.1 生理指标变化分析 8
3.2 并发症发生率对比 8
3.3 预后改善情况评价 9
第四章 液体复苏策略优化建议 11
4.1 个性化治疗方案探索 11
4.2 监测指标体系完善 11
4.3 临床路径规范化建设 12
结 论 13
参考文献 14
致 谢 15
