摘要
目的:探讨限制性液体复苏对脓毒性休克患者的疗效及安全性分析。方法:将2016年1月-2018年12月于笔者所在医院治疗的97例脓毒性休克患者随机分为对照组(n=48)和观察组(n=49)。对照组给予快速、充分液体复苏治疗,观察组给予限制性液体复苏治疗。分析比较两组患者机械通气时间,入住ICU时间,补液量,复苏7 d后患者心率(HR)、CVP、平均动脉压(MAP)、乳酸水平、每分输出量(CO)、心室射血分数(LVEF)、血浆心肌肌钙蛋白(cTnI),APACHEⅡ评分、MODS评分,并发症发生率等情况。结果:观察组机械通气时间、入住ICU时间、补液量、术中出血量显著低于对照组,24 h乳酸清除率高于对照组(P<0.05);两组患者治疗后HR、乳酸水平较治疗前显著降低,CVP、MAP较治疗前显著升高,且观察组治疗后HR、乳酸水平显著低于对照组,CVP、MAP显著高于对照组,差异均有统计学意义(P<0.05);治疗后观察组CO、LVEF显著高于对照组,cTnI低于对照组(P<0.05);两组患者APACHEⅡ评分及MODS评分均较治疗前显著下降,且观察组治疗后APACHEⅡ评分及MODS评分较对照组明显下降(P<0.05);治疗过程中,观察组患者MODS、ARDS、DIC发病率显著低于对照组(P<0.05)。结论:限制性液体复苏可以提高脓毒性休克患者疗效,显著改善血流动力学和心肌功能,减少并发症的发生。
Objective:To investigate the efficacy and safety analysis of restrictive fluid resuscitation in patients with septic shock.Method:A total of 97 patients with septic shock treated in our hospital from January 2016 to December 2018 were randomly divided into control group(48 cases)and observation group(49 cases).The control group received rapid and adequate fluid resuscitation therapy,while the observation group received restrictive fluid resuscitation therapy.Compared two groups of patients with mechanical ventilation time and ICU admission time,rehydration,recovery after 7 d patients’heart rate(HR),CVP,mean arterial pressure(MAP),lactic acid levels,per minute output(CO),ventricular ejection fraction(LVEF),plasma cardiac troponin(cTnI),APACHEⅡgrade,MODS,complication rates,and so on.Result:Mechanical ventilation time,ICU stay,fluid volume and intraoperative blood loss in the observation group were significantly lower than those in the control group,and the lactate clearance rate at 24 h was higher than that in the control group(P<0.05).After treatment,the levels of HR and lactic acid,CVP and MAP in the two groups were significantly lower than those in the control group,and the levels of CVP and MAP were significantly higher than those in the control group(P<0.05).After treatment,CO and LVEF in the observation group were significantly higher than those in the control group,and cTnI was lower than those in the control group(P<0.05).Two groups of patients with APACHEⅡscores and MODS score was decreased significantly,and after treatment observation group APACHEⅡscores and MODS score significantly decreased,compared with the control group(P<0.05).During the treatment,the level of MODS,ARDS and DIC in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Restrictive fluid resuscitation can improve the efficacy of septic shock patients,significantly improve hemodynamics and myocardial function,and reduce the incidence of complications.
作者
陈瑶
刘丽英
CHEN Yao;LIU Liying(Qujing First People’s Hospital,Qujing 655000,China)
出处
《中外医学研究》
2019年第36期14-16,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
限制性液体复苏
脓毒性休克
血流动力学
心肌功能
Restrictive liquid resuscitation
Septic shock
Hemodynamics
Myocardial function
