中分子羟乙基淀粉对脓毒性休克病人胃粘膜灌注的影响  

Influence of hydroxyethyl starch on gastric mucosal perfusion of patients with septic shock

作　　者：吴建浓 雷澍 方强[2] 

机构地区：[1]浙江中医学院附属医院ICU室,杭州310009 [2]浙江大学医学院第一附属医院,杭州310003

出　　处：《江西医药》2006年第8期535-538,共4页Jiangxi Medical Journal

摘　　要：目的观察中分子羟乙基淀粉(130/0.4)对脓毒性休克病人胃粘膜灌注的影响。方法收集20例脓毒性休克病人,按照2004年脓毒性休克治疗指南中的复苏目标,用中分子羟乙基淀粉(130/0.4)进行液体复苏。观察复苏前、后血流动力学指标、动脉乳酸浓度(ABL)和局部二氧化碳压力差(Pg-aCO2),即胃粘膜和动脉血二氧化碳压力差。结果中分子羟乙基淀粉(130/0.4)复苏后,Pg-aCO2从15.49mmHg降至11.72mmHg(P<0.01),PAWP、CI、SVRI、DO2及ABL等指标升高(P<0.01);Pg-aCO2与ABL呈显著正相关性(r=0.546,P<0.05),而与CI、DO2、VO2无显著相关性;中分子羟乙基淀粉(130/0.4)复苏前后,血清肌酐、PT、APTT和血小板无明显变化(P>0.05)。结论中分子羟乙基淀粉(130/0.4)能改善脓毒性休克病人胃粘膜的灌注,对肾功能和凝血功能无明显影响。Objective To observe the effect of gastric mucosal perfusion of hydroxyethyl starch（130/0.4）to septic shock. Methods Selected 20 patients with septic shock, according to the resuscitation goals of therapy guideline on septic shock, practice fluid resuscitation with hydroxyethyl starch（130/0.4）. Hemodynamics, artery blood lactate concentration and the partial pressure of carbon dioxide gap（Pg-aCO2）, which is difference betweenPgCO2, and PaCO2., were observed before and after fluid resuscitation. Results After fluid resuscitation with hydroxyethyl starch（130/0.4）, Pg-aCO2 decreased from 15.49mmHg to 11.72mmHg（P〈0.01）,PAWP, CI, SVRI, DOs and artery blood lactate concentration rised（P〈0.01）, PVRI decreased（P〈0.01）; moreover, Pg-aCO2 and ABL had significant correlation （r=0.546, P〈0.05）. Pg-aCP2 was no related to CI, DO2 and VO2; There were no notable change（P〉0.05） in blood Cr, PT, APTT and blood platelet no matter fluid resuscitation. Conclusion Hydroxyethyl starch （130/0.4）improves gastric mucosal perfusion of patients with septic shock, and has no side effect on renal function and coagulatin.

关 键 词：中分子羟乙基淀粉(130/0.4) 脓毒性休克 胃粘膜灌注 局部二氧化碳压力差 

分 类 号：R459.7[医药卫生—急诊医学]