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内镜逆行胰胆管造影术后胰腺炎患者静脉输液量增加与住院时间缩短的关联。

Association of greater intravenous volume infusion with shorter hospitalization for patients with post-ERCP pancreatitis.

作者信息

Sagi Sashidhar V, Schmidt Suzette, Fogel Evan, Lehman Glen A, McHenry Lee, Sherman Stuart, Watkins James, Coté Gregory A

机构信息

Department of Medicine, Division of Gastroenterology, Indiana University School of Medicine, Indianapolis, Indiana, USA.

出版信息

J Gastroenterol Hepatol. 2014 Jun;29(6):1316-20. doi: 10.1111/jgh.12511.

Abstract

BACKGROUND AND AIM

There are no data specifically correlating early intravenous volume infusion (IVI) with the length of hospitalization for postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).

METHODS

We conducted a retrospective cohort study of patients admitted within 24 h after ERCP to our institute with PEP. IVI during the first 24 h after ERCP was assessed. Primary outcome was severity of PEP, defined by length of hospitalization according to consensus guidelines: mild ≤ 3, moderate 4-10, and severe > 10 days.

RESULTS

Of 72 eligible patients, 41 (56.9%) had mild and 31 (43.1%) moderate/severe PEP. Both groups had comparable demographics, indications, and procedural factors except patients with moderate/severe PEP were older (median age 49 vs 36 years, P = 0.05) and more likely to be discharged and readmitted within the first 24 h (41.9% vs 14.6%, P < 0.01). Patients with mild PEP received significantly greater IVI during the first 24 h (2834 mL [2046, 3570] vs 2044 mL [1227, 2875], P < 0.02) and 50% more fluid post-ERCP (2270 mL [1435, 2961] vs 1515 [950-2350], P < 0.02) compared with those with at least moderate PEP.

CONCLUSION

In patients with PEP, greater IVI during the first 24 h after ERCP is associated with reduced length of hospitalization. Lower IVI was more commonly observed in individuals who were discharged and then readmitted during the first 24 h.

摘要

背景与目的

目前尚无专门数据表明内镜逆行胰胆管造影术(ERCP)后胰腺炎(PEP)早期静脉输液量(IVI)与住院时长之间的相关性。

方法

我们对在我院因PEP于ERCP后24小时内入院的患者进行了一项回顾性队列研究。评估了ERCP后最初24小时内的静脉输液量。主要结局是PEP的严重程度,根据共识指南,依据住院时长定义:轻度≤3天,中度4 - 10天,重度>10天。

结果

72例符合条件的患者中,41例(56.9%)为轻度PEP,31例(43.1%)为中度/重度PEP。两组在人口统计学、适应证和操作因素方面具有可比性,但中度/重度PEP患者年龄更大(中位年龄49岁对36岁,P = 0.05),且在最初24小时内更有可能出院后再入院(41.9%对14.6%,P < 0.01)。与至少中度PEP患者相比,轻度PEP患者在最初24小时内接受的静脉输液量显著更多(2834 mL [2046, 3570]对2044 mL [1227, 2875],P < 0.02),且ERCP后输液量多50%(2270 mL [1435, 2961]对1515 [950 - 2350],P < 0.02)。

结论

在PEP患者中,ERCP后最初24小时内更多的静脉输液量与缩短住院时长相关。较低的静脉输液量更常见于在最初24小时内出院后再入院的患者。

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