急性胰腺炎早期流体治疗轨迹:一项回顾性队列研究
Jianhua Wan1, Shixuan Xiong1, Yaoyu Zou1
1Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, People's Republic of China.
World journal of emergency surgery : WJES
|December 4, 2025
概括
在急性胰腺炎 (AP) 中,个性化流体治疗是复杂的. 确定五种不同的流体治疗轨迹表明,高负荷或波动的流体管理显著增加死亡风险.
科学领域:
- 关键护理医学 关键护理医学
- 胃肠病学 胃肠病学
- 临床流体疗法临床流体疗法
背景情况:
- 在急性胰腺炎 (AP) 中,早期流体治疗的个性化管理具有挑战性.
- 传统研究往往忽略了动态流体平衡轨迹.
研究的目的:
- 在AP患者中识别不同的动态流体治疗轨迹.
- 分析这些轨迹与住院死亡率之间的关联.
主要方法:
- 对3,142名AP患者进行了回顾性队列研究.
- 隐性类生长建模 (LCGM) 以在72小时内确定流体治疗轨迹.
- 多变量考克斯回归和3D表面图分析以评估死亡风险和相互作用.
主要成果:
- 确定了五种不同的动态流体治疗轨迹.
- 持续高负荷 (HSG5) 和中度高波动 (MHFG4) 组显示死亡风险明显增加.
- 高累积液体治疗 (CumFWR) 和异常血红素水平与死亡率增加有关.
结论:
- 在AP中存在不同的动态流体治疗模式.
- 高负荷或波动性流体治疗增加了死亡风险.
- 动态监测流体治疗轨迹和血红素可以优化AP管理.
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