早期目标指导的液体复苏提高有机磷农药中毒性休克救治率的临床研究  

Clinical study of early goal-directed fluid resuscitation to improve the treatment rate of organophosphorus pesticide poisoning shock

作　　者：张珂[1] 冯慧[1] 周凤芹[1] Zhang Ke;Feng Hui;Zhou Feng-qin(The Affiliated Hospital of Jining Medical University, Shandong Province, Heze City, Heze, Shandong, 274300, China)

机构地区：[1]济宁医学院附属湖西医院,山东菏泽274300

出　　处：《当代医学》2017年第24期57-60,共4页Contemporary Medicine

摘　　要：目的探讨早期目标指导的液体复苏治疗对有机磷农药中毒性休克患者的救治率的影响。方法以31例有机磷农药中毒性休克的患者为临床研究对象,随机分为对照组16例,给予常规治疗+经验抗休克治疗,治疗组15例,给予常规治疗+早期目标指导的液体复苏治疗。观察两组患者治疗开始前及治疗后12 h、24 h、48 h,各时间点收缩压、血乳酸、C反应蛋白、APACHEⅡ评分、机械通气时间及死亡率的差异。结果常规治疗+早期目标指导的液体复苏治疗较常规治疗+经验抗休克治疗患者的机械通气天数及死亡率明显降低,差异有统计学意义(P<0.05),治疗组较对照组收缩压明显增高,血乳酸及APACHEII评分明显降低,而C反应蛋白升高程度明显降低,两组差异有统计学意义(P<0.05)。结论早期目标指导的液体复苏治疗可以迅速改善收缩压、降低血乳酸、APACHEII评分,减缓C反应蛋白升高程度及改善全身炎症反应,从而提高有机磷农药中毒性休克的临床救治率。Objective To investigate the effect of early goal-directed fluid resuscitation on the treatment of patients with organophosphorus pesticide poisoning.Methods31cases of organophosphorus pesticide poisoning shock patients for the clinical study,16patients were randomly divided into control group,routine treatment+experience of anti shock treatment,15cases in the treatment group were given conventional treatment+liquid resuscitation in the treatment of early goal-directed.The differences of12h,24h,48h,systolic blood pressure,blood lactic acid,C reactive protein,APACHEII score,mechanical ventilation time and mortality of two groups before and after treatment were observed.Results The duration of mechanical ventilation and mortality results in fluid resuscitation of conventional treatment and early goal-directed therapy compared with conventional treatment+anti shock treatment experience of patients decreased significantly,the difference was statistically significant(P<0.05),the treatment group than the control group significantly increased systolic blood pressure,blood lactate and APACHEII score decreased significantly,while C C-reactive protein increased significantly decreased,there was significant difference between two groups(P<0.05).Conclusion Early goal-directed fluid resuscitation therapy can rapidly improve the systolic blood pressure,lower blood lactate and APACHEII score,slow C elevated CRP degree and improve the systemic inflammatory response,so as to improve the organophosphorus pesticide poisoning shock clinical cure rate.

关 键 词：早期目标指导的液体复苏 有机磷农药 中毒性休克 

分 类 号：R595.4[医药卫生—内科学]