以血乳酸清除率为指导对脓毒性休克患者进行早期液体复苏治疗的效果分析  

The effect of early fluid resuscitation in patients with septic shock was analyzed based on blood lactate clearance

作　　者：王旭东 Wang Xudong(Rongxian people's hospital of sichuan province,Sichuan Zigong 643100)

机构地区：[1]四川省荣县人民医院

出　　处：《当代医药论丛》2019年第18期86-87,共2页

摘　　要：目的:分析并研究以血乳酸清除率为指导对脓毒性休克患者进行早期液体复苏治疗的临床效果。方法:选择2017年1月至2018年12月四川省荣县人民医院收治的60例脓毒性休克患者作为研究对象。将这些患者平均分为对照组(n=30)与观察组(n=30)。对两组患者均进行早期液体复苏治疗。在此过程中,以血乳酸清除率为指导对观察组患者进行早期液体复苏治疗,以中心静脉血氧饱和度为指导对对照组患者进行早期液体复苏治疗,然后比较两组患者的各项临床指标。结果:观察组患者治疗的有效率高于对照组患者,其死亡率低于对照组患者,治疗后其尿量多于对照组患者,差异有统计学意义,P<0.05。治疗后,观察组患者的APACHE-Ⅱ评分低于对照组患者,其入住ICU的时间和住院的时间均短于对照组患者,差异有统计学意义,P<0.05。结论:以血乳酸清除率为指导对脓毒性休克患者进行早期液体复苏治疗的效果显著,可改善其病情,降低其死亡率,缩短其入住ICU的时间和住院的时间。objective: to analyze and study the clinical effect of early fluid resuscitation in septic shock patients guided by blood lactate clearance rate. Methods: 60 patients with septic shock admitted to rongxian people’s hospital of sichuan province from January 2017 to December 2018 were selected as subjects. These patients were equally divided into control group(n=30) and observation group(n=30). Both groups were treated with early fluid resuscitation. In this process, the patients in the observation group were treated with early liquid resuscitation with the blood lactate clearance rate as the guide, and the patients in the control group were treated with early liquid resuscitation with the central venous oxygen saturation as the guide, and then the clinical indicators of the patients in the two groups were compared. Results: the effective rate of the observation group was higher than that of the control group, the mortality rate was lower than that of the control group, and the urine volume was higher than that of the control group after treatment, the difference was statistically significant(P < 0.05). After treatment, the observation group of patients with APACHE-Ⅱ score lower than the control group, the ICU admission time and hospitalization time were shorter than the control group patients, the difference was statistically significant, P < 0.05. Conclusion: early fluid resuscitation in patients with septic shock, guided by serum lactate clearance rate, can significantly improve their condition, reduce their mortality, and shorten their stay in ICU and stay in hospital.

关 键 词：血乳酸清除率 脓毒性休克 早期液体复苏治疗 中心静脉血氧饱和度 

分 类 号：R459.7[医药卫生—急诊医学]