Department of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal.
Department of Medicine, Pokhara Academy of Health Sciences, Pokhara, Nepal.
PLoS One. 2022 Jan 28;17(1):e0263221. doi: 10.1371/journal.pone.0263221. eCollection 2022.
Acute pancreatitis (AP) is a common presentation in patients admitted with acute abdomen. Whether Ringers lactate (RL) or Normal Saline (NS) as a resuscitation fluid is better still remains unclear. The aim of this study is to compare the efficacy of RL and NS in terms of control of systemic inflammation by measuring indirect markers specifically Systemic Inflammation Response Syndrome (SIRS) scores and C- Reactive Protein (CRP) level.
This was an open label randomized trial conducted in a tertiary level hospital of Nepal. Ethical approval was obtained prior to the study. Patients with acute pancreatitis were randomized to either RL or NS group for the fluid resuscitation. The fluid was given as per the study protocol for three days for hydration. Baseline SIRS and CRP were recorded on admission and subsequently as defined. All the data were analyzed using SPSS ver 20.0 software.
Total 51 patients were enrolled, 26 in RL and 25 in NS group. The commonest etiology of AP was alcohol (84.31%). SIRS was present in 46.2% and 64.0% of patients in RL and NS group respectively (p = 0.20) on admission. At least one SIRS criteria was still present in 44.0% of patients in the NS group compared to only 15.4% in the RL group after 24 hours (p = 0.025). The baseline CRP were comparable in both the groups. However after 72 hours, the increment of CRP was more in the NS group compared to the RL group; median value of 14.2 mg/dl (12.15, 16.45) and 22.2 mg/dl (18.20, 30.60) in RL and NS group respectively (p<0.001).
Ringers lactate was associated with a reduction in systemic inflammation compared to normal saline in patients with acute pancreatitis. Incidence of SIRS at 72 hours and occurrence of local complications were however similar in both the groups.
急性胰腺炎（AP）是急性腹痛患者住院的常见表现。在复苏液中使用林格氏乳酸盐（RL）还是生理盐水（NS）更好仍不清楚。本研究的目的是通过测量间接标志物（特别是全身炎症反应综合征[SIRS]评分和 C 反应蛋白[CRP]水平）来比较 RL 和 NS 在控制全身炎症方面的疗效。
这是在尼泊尔一家三级医院进行的开放标签随机试验。在研究之前获得了伦理批准。将急性胰腺炎患者随机分为 RL 或 NS 组进行液体复苏。根据研究方案，在三天内给予液体以进行水化。入院时记录基线 SIRS 和 CRP，并随后按定义进行记录。所有数据均使用 SPSS ver 20.0 软件进行分析。
共纳入 51 例患者，RL 组 26 例，NS 组 25 例。AP 的最常见病因是酒精（84.31%）。入院时 RL 和 NS 组分别有 46.2%和 64.0%的患者存在 SIRS（p = 0.20）。24 小时后，NS 组仍有 44.0%的患者至少存在一项 SIRS 标准，而 RL 组仅为 15.4%（p = 0.025）。两组的基线 CRP 水平相当。然而，72 小时后，NS 组的 CRP 升高幅度大于 RL 组；RL 组和 NS 组的中位数分别为 14.2mg/dl（12.15，16.45）和 22.2mg/dl（18.20，30.60）（p<0.001）。
与生理盐水相比，急性胰腺炎患者使用林格氏乳酸盐可降低全身炎症。然而，两组患者在 72 小时时 SIRS 的发生率和局部并发症的发生情况相似。
