早期目标导向性利尿对重症患者预后的影响  

Effects of early goal-directed diuresis therapy on the outcomes of critical ill patients

作　　者：陈秀凯[1] 丁琪[1] 刘大为[2] 李文雄[1] 黄立锋[1] 隋峰[1] 郑悦[1] 赵松[1] 

机构地区：[1]首都医科大学附属北京朝阳医院外科ICU,100020 [2]中国医学科学院北京协和医学院北京协和医院重症医学科

出　　处：《中华医学杂志》2013年第23期1815-1818,共4页National Medical Journal of China

摘　　要：目的探讨早期目标导向性利尿对重症患者预后的影响。方法入选病例在保证血流动力学稳定的前提下，分次给予速尿5～40mg，以中心静脉压（CVP）是否降至目标值8mmHg以下为标准，将患者分为达标组和未达标组，比较两组患者在ICU住院期间的存活率、给予治疗后的住ICU时间和机械通气时间。结果共56例患者入选，其中达标组30例，未达标组26例。达标组存活率显著高于未达标组（96．7％与84．6％，P〈0．05）；达标组利尿治疗后的住ICU时间（4．4±3．6）d和机械通气时间（1．2±1．1）d显著低于未达标组的（12．5±11．7）d与（9．8±9．6）d（P〈0．05）。结论早期目标导向性利尿可改善重症患者的预后。Objective To evaluate the effects of early goal-directed diuresis therapy on the outcomes of critical ill patients. Methods A total of 56 critical patients enrolled received an injection of furosemide 5 -40 mg under a precondition of stable hemodynamics. They were divided into two groups： standard group [ Central venous pressure （CVP） decreased below 8 mm Hg] （ n = 30） and control group （ if not） （n = 26） depending on the goal of CVP. And the differences of survival rate, intensive care unit （ICU） days and ventilation days after diuresis therapy were compared between two groups. Results The survival rate of standard group was significantly higher than that of control group （96. 7% vs 84. 6% , P 〈 0. 05 ） while the ICU days （4.4 ± 3.6 days） and ventilation days（ 1. 2 ± 1.1 days） after diuresis therapy of standard group were significantly shorter than that of control group （ 12. 5 ± 11.7 and 9.8 ± 9.6 days, P 〈0. 05）. Conclusion Early goaldirected diuresis therapy can improve the prognosis of critical ill patients.

关 键 词：危重病 利尿 预后 

分 类 号：R45[医药卫生—治疗学]