感染性休克患者输血治疗的有效性研究  

Effectiveness of blood transfusion in treatment of patients with septic shock

作　　者：陈宝友[1] 张晓红 张振周[1] 吴光远[1] 李建忠[1] 

机构地区：[1]濮阳市人民医院输血科,河南濮阳457000 [2]濮阳市妇幼保健院妇产科,河南濮阳457000

出　　处：《中华医院感染学杂志》2016年第6期1250-1252,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技厅基金资助项目(XF250163)

摘　　要：目的探讨感染性休克患者输血治疗的有效性,为感染性休克的治疗提供参考依据。方法选取2010年1月-2015年6月住院治疗的感染性休克患者60例,随机分为输血组与未输血组各30例,给予治疗原发病、纠正酸中毒及电解质紊乱、抗感染、利尿、强心等基础治疗,输血组同时输注全血200~400ml;记录患者复苏24h时液体总量、每小时尿量、中心静脉压（CVP）、平均动脉压（MAP）、心输出量（CO）、全心舒张末期容积指数（GEDVI）,复苏前及复苏3d时患者血清降钙素原（PCT）、C-反应蛋白（CRP）水平变化,肺水肿发生率及28d内病死率。结果两组复苏24h时每小时尿量、CVP、MAP、GEDVI均较复苏前明显改善（P〈0.05）,输血组复苏24h时液体总量少于未输血组（P〈0.05）,每小时尿量多于未输血组（66.08±54.83）ml（P〈0.05）;两组复苏3d时血清PCT、CRP均较复苏前明显下降（P〈0.05）,输血组复苏3d时血清PCT、CRP低于未输血组;输血组与未输血组肺水肿发生率分别为6.67%、13.33%,比较差异无统计学意义,28d内病死率输血组为0,未输血组为16.67%,差异均有统计学意义（P〈0.05）。结论感染性休克患者在常规液体复苏基础上适当进行输血治疗,可减少输液总量,增强机体抗炎症反应能力,有利于降低病死率。OBJECTIVE To explore the effectiveness of blood transfusion in treatment of patients with septic shock so as to provide guidance for treatment of the patients with septic shock.METHODS A total of 60 patients with septic shock who were hospitalized for treatment from Jan 2010 to Jun 2015 were enrolled in the study and randomly divided into the blood transfusion group and the non-blood transfusion group,with 30 cases in each.The enrolled patients were given the basic treatments,including the treatment of primary diseases,correction of acidosis and electrolyte disorder,anti-infection,diuresis,and cardiac foundation treatment;the blood transfusion group was treated with transfusion of whole blood for 200-400 ml at the same time.The total volume of fluids,urine output per hour,central venous pressure（CAP）,mean arterial pressure（MAP）,cardiac output（CO）,and ventricular end-diastolic volume index（EDVI）were recorded after the recovery for 24hours;the changes of the levels of serum procalcitonin（PCT）and C-reactive protein（CRP）were observed before the recovery and after the recovery for 3days,and the incidence of pulmonary edema and mortality rate in 28 days were analyzed.RESULTS The urine output per hour,CVP,MAP,and EDVI of the two groups were improved more significantly after the recovery for 24 hours than before the recovery（P0.05）;the total volume of fluids of the blood transfusion group was less than that of the non-blood transfusion group after the recovery for 24hours（P0.05）;the urine output per hour of the blood transfusion group was more than that of the non-blood transfusion group（66.08±54.83）ml（P0.05）.The levels of serum PCT and CRP of the two groups declined more remarkably after the recovery for 3days than before the recovery（P0.05）;the levels of serum PCT and CRP of the blood transfusion group were lower than those of the non-blood transfusion group after the recovery for 3days.The incidence rate of pulmonary edema was 6.67%in the blood transfusion group,13.33%in th

关 键 词：感染性休克 输血 液体复苏 

分 类 号：R631.4[医药卫生—外科学]