早期侵袭性水化与轻度急性胰腺炎的阿片类药物使用减少和再入院有关
Shreyans Doshi1, Hong Liang2, Hale Z Toklu3,4
1Augusta University, GA.
HCA healthcare journal of medicine
|July 10, 2023
概括
在轻度急性胰腺炎 (AP) 中,积极的水合降低了肌素水平和阿片类药物的使用. 在AP患者中,早期的侵略性液体复苏会导致更好的结果和更少的再入院.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
- 关键的护理关键的护理
背景情况:
- 急性胰腺炎 (AP) 是一个常见的胃肠道入院.
- 目前的AP治疗是支持性的,主要是静脉注射液体.
- 对于轻度AP的最佳液体水化策略缺乏共识.
研究的目的:
- 为了研究积极的水分对轻度AP患者结局的影响.
- 为了比较不同静脉输液速率的结果,在轻度AP中.
主要方法:
- 在12家医院 (2015-2017) 中对500名轻度AP患者进行了回顾性分析.
- 根据前12小时的液体体积,患者被分为三个水分组.
- 评估的结果包括实验室结果,停留时间和止痛药的使用.
主要成果:
- 与标准水合 (0-1.5毫升/公斤/小时) 相比,积极的水合 (>3毫升/公斤/小时) 显著降低了肌素水平.
- 接受过度补水的患者需要少用阿片类止痛药.
- 过度补水与30天再入院的可能性较低有关.
结论:
- 在轻度AP中,积极的水合与改善的临床标志物和减少止痛药的需求有关.
- 尽管有好处,但在社区医院中,积极的水化并未得到一致的实施.
- 需要进一步的研究和指导方针的制定,以标准化轻度AP的早期侵略性水化方案.
相关概念视频
Acute Pancreatitis II: Clinical Manifestations and Management
150
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
150
Chronic Pancreatitis II: Collaborative Care
115
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
115
Acute Pancreatitis I: Introduction
409
Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
409
Chronic Pancreatitis I: Introduction
116
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
116
Acute Kidney Injury V: Interprofessional Care
26
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
26
Appendicitis-II: Diagnostic Studies and Management
100
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
100


