含葡萄糖的液体对急性胰腺炎结果的影响:一个多中心的回顾性分析
Hsing-Chien Wu1, Kuo-Liong Chien2, Chieh-Chang Chen3
1Department of Medicine, National Taiwan University Cancer Center, National Taiwan University Hospital, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
概括
在急性胰腺炎 (AP) 中含高葡萄糖的液体与更糟糕的结果有关. 这项研究发现,在AP患者的葡萄糖液密度较高的情况下,器官衰竭和ICU入院的风险增加.
科学领域:
- 关键护理医学 关键护理医学
- 胃肠病学 胃肠病学
- 流体管理流体管理
背景情况:
- 液体复苏对于急性胰腺炎 (AP) 患者至关重要.
- 含葡萄糖的液体对AP结果的影响尚未得到充分证实.
- 这项研究调查了葡萄糖液密度和AP并发症之间的关联.
研究的目的:
- 为了检查含葡萄糖液体的管理和急性胰腺炎的不良结果之间的关系.
- 为了确定复苏液中较高的葡萄糖密度是否会增加AP中器官衰竭和死亡的风险.
主要方法:
- 一个多中心的回顾性队列研究1,146个AP患者 (2015-2018).
- 葡萄糖密度 (g/dL) 计算在第一天;高密度超过了中位数.
- 终点包括早期器官衰竭 (OF),30天OF,ICU入院和90天死亡率,通过后勤回归和Cox模型进行分析.
主要成果:
- 接受高葡萄糖密度液体 (>5 g/dL) 的患者表现出早期OF风险增加 (aOR 1.69).
- 呼吸衰竭 (aOR1.88),心血管衰竭 (aOR3.59) 和ICU入院 (aOR2.06) 之间发现了显著的关联.
- 观察到剂量-反应关系,并且30天的OF风险升高 (aHR1.70).
结论:
- 复苏液中的葡萄糖密度升高与器官衰竭和AP中的ICU入院风险增加有关.
- 这些发现表明,在AP患者使用高葡萄糖液体时,应谨慎使用.
- 进一步的研究可能会澄清AP管理的最佳流体选择.
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