休克指数对感染性休克患者预后的预测价值  

The value of the shock value in predicting prognosis of patients with severe sepsis

作　　者：余愿[1] 付朝晖[1] 徐梦[2] 尚游[1] 梅亚凡 

机构地区：[1]华中科技大学同济医学院附属协和医院重症医学科,武汉430022 [2]洪湖市人民医院ICU

出　　处：《临床急诊杂志》2014年第9期535-537,共3页Journal of Clinical Emergency

摘　　要：目的:研究休克指数(SI)对感染性休克患者预后的预测作用。方法:研究选入98例诊断为严重感染或感染性休克的患者,记录早期复苏开始时、复苏6h后的情况及6h后的休克指数。然后根据复苏6h后的情况分为A、B、C、D四组。A组为实现EGDT同时SI≤0.7,B组为实现EGDT但SI>0.7,C组未能实现EGDT但SI≤0.7,D组未能实现EGDT同时SI>0.7。比较四组之间6h乳酸清除率及预后。结果:6h乳酸清除率A组与其他3组均有差异,B、C两组间无差异,D与其他3组均有差异。A组的28d病死率低于D组,其余组间无差异。实现EDGT目标患者6h乳酸清除率及28d病死率均优于未实现EGDT目标者。SI≤0.7组患者6h乳酸清除率及28d病死率均优于SI>0.7组患者。结论:感染性休克患者在早期复苏后,实现EGDT组预后优于未实现EGDT组,SI≤0.7组预后优于SI>0.7组。如能同时实现EGDT目标和SI≤0.7,则预后显著优于其他组。SI能作为经早期复苏后感染性休克患者预测预后的指标。Objective：To analyze whether the shock index （SI） can predict the prognosis ot patients with severe sepsis or septic shock or not. Method： A postoperative study was conducted for 98 severe sepsis or septic shock patients, we record the parameters and shock index at the begin and six hours later of the resuscitation. The patients were divided into four groups. Patients in group A achieved all the four goals of EGDT and SI≤0.7, the group B a chieved all the four goals of EGDT but SI≤0.7, the group C did not achieve all the four goals of EGDT but SI≤0. 7,the group D did not achieve all the four goals of EGDT and SI≤0. 7. The lactate clearance and the prognosis were compared for the four groups. Result：Six hours lactate clearance rate in group A and the other three groups all had differences. No difference between groups of B and C were found. Group D and the other three groups all had differences. The 28 day mortality rate of Group A was lower than D group, no difference between any other two groups were found. The patients achieved EDGT goals were superior to the patients who didn＇t achieve EGDT goals in 6 hours lactate clearance rate and 28 days mortality. The patients with SI≤0.7 were superior to the patients with SI≤0.7 in 6 hours lactate clearance rate and 28 days mortality. Conclusion： The prognosis of the patients with SI≤0.7 were superior to the patients with SI≤0.7. The prognosis of the patients achieved the EGDT goals were superior to the patients did not achieved the EGDT goals. The prognosis was best in patients whom a chieved EGDT goals and SI≤0.7. The shock index （SI） can predict the prognosis of patients with severe sepsis or septic shock.

关 键 词：感染性休克 早期复苏 休克指数 EGDT 乳酸清除率 

分 类 号：R441.9[医药卫生—诊断学]