重庆医学2013，Vol.42Issue(20)：2352-2355,2358,5.DOI:10.3969/j.issn.1671-8348.2013.20.017
不同液体选择对脓毒性休克早期复苏及预后的影响
The effect of different fluid on early resuscitation and prognosis of septic shock
徐盈 1钟玲 1陈国兵 1吴海燕 1傅小雨1
作者信息
- 1. 云南省第一人民医院/昆明医科大学附属医院急诊ICU,昆明 650032
- 折叠
摘要
Abstract
Objective To study the effect of different fluid on early resuscitation of patients with septic shock by observing PiCCO and comparing hemodynamics,lactate clearance rate and mortality rate.Methods A total of 100 patients with septic shock were randomly divided into normal saline group(NS group),hydroxyethyl starch resuscitation group(HES group),4 ％ hypertonic saline resuscitation group(4％ NaCl group),hydroxyethyl starch 40 injection group(Holm group).Each group has 25 cases of patients.Changes of hemodynamic parameters,blood lactate clearance and mortality rate after treatment were monitored by PiCCO.Results Heart rate(HR) in four groups significantly reduced(P＜0.05).Central venous pressure(CVP),mean arterial pressure(MAP),cardiac output,intrathoracic blood volume index(ITBVI) significantly increased (P＜ 0.05).Extravascular lung water index in NS group increased significantly(P＜0.05).Liquid volume and the total recovery of liquid in 4 ％ NaCl group and Holm group were significantly less than those of NS group HES group(P＜0.01);Mean arterial blood pressure in Holm group significantly increased compared with the other three groups after recovery of 1 h(P＜0.01) ;Blood lactate clearance rate was higher than the other three groups in 24 h(P＜0.01) ;There were no difference in serious infection-related organ failure assessment(SOFA score),physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ) score and 28 d mortality among four groups(P＞0.05).While the 28 d mortality rate in the Holm group showed a downward trend.Conclusion Four kinds of liquid can improve the hemodynamic state in the early fluid resuscitation in septic shock.Using Holm fluid can increases blood pressure rapidly and maintain the total volume in the less liquid.关键词
休克/脓毒性休克/液体复苏/血乳酸清除率Key words
shock / shock, septic/ fluid resuscitation/ blood lactate clearance引用本文复制引用
徐盈,钟玲,陈国兵,吴海燕,傅小雨..不同液体选择对脓毒性休克早期复苏及预后的影响[J].重庆医学,2013,42(20):2352-2355,2358,5.
