早期集束化治疗对感染性休克的临床效果分析  

Clinical effect of septic shock treated by early goal directed therapy

作　　者：陈伟宏[1] CHEN Wei-hong(Department of Intensive Care Unit,Shantou Central Hospital,Shantou 515000,China)

机构地区：[1]汕头市中心医院重症医学科,515000

出　　处：《中国实用医药》2020年第14期33-35,共3页China Practical Medicine

摘　　要：目的研究早期集束化治疗对感染性休克的临床效果。方法72例感染性休克患者,随机分为观察组(38例)及对照组(34例)。对照组患者进行常规治疗,观察组患者在3 h内采用早期集束化治疗。对比两组治疗3及24 h后的尿量、平均动脉压、血乳酸水平;血管活性药物使用时间、重症监护室时间以及临床死亡率。结果观察组治疗3及24 h后的尿量分别为(50.1±9.4)、(89.4±10.6)ml/h,均多于对照组的(25.6±8.7)、(46.3±18.2)ml/h;平均动脉压分别为(66.4±5.1)、(65.2±4.4)mm Hg(1 mm Hg=0.133 kPa),均高于对照组的(61.3±4.2)、(60.9±3.6)mm Hg;血乳酸分别为(12.6±2.1)、(4.8±1.7)mmol/L,均低于对照组的(14.7±1.9)、(7.2±1.4)mmol/L;差异均具有统计学意义(P<0.05)。观察组血管活性药物应用时间为(7.8±1.5)d、重症监护室时间为(5.9±1.4)d,均短于对照组的(9.9±1.7)、(8.2±1.6)d,临床死亡率为5.26%,低于对照组的20.59%,差异均具有统计学意义(P<0.05)。结论在感染性休克患者中采用早期集束化治疗,可以有效的改善患者的尿量、平均动脉压、快速降低血乳酸水平、减短重症监护室时间,降低临床死亡率,有显著的临床运用价值,值得推广应用。Objective To study the clinical effect of infective shock treated by early goal directed therapy.Methods A total of 72 septic shock patients were randomly divided into observation group(38 cases)and control group(34 cases).The control group received conventional therapy,and the observation group received early goal directed therapy within 3 h.The urine volume,mean arterial pressure,blood lactate level after 3 and 24 h of treatment,usage of vasoactive agent,time of intensive care unit,and clinical mortality were compared between the two groups.Results After 3 and 24 h of treatment,the urine volume of the observation group were(50.1±9.4)and(89.4±10.6)ml/h respectively,which were more than those of the control group(25.6±8.7)and(46.3±18.2)ml/h,mean arterial pressure were(66.4±5.1)and(65.2±4.4)mm Hg(1 mm Hg=0.133 kPa),which were higher than those of the control group(61.3±4.2)and(60.9±3.6)mm Hg,and blood lactate level were(12.6±2.1)and(4.8±1.7)mmol/L,which were lower than those of the control group(14.7±1.9)and(7.2±1.4)mmol/L.The difference was statistically significant(P<0.05).The usage of vasoactive agent(7.8±1.5)d and time of intensive care unit(5.9±1.4)d of the observation group were shorter than those of the control group(9.9±1.7)and(8.2±1.6)d,and clinical mortality 5.26%was lower than that of the control group 20.59%.The difference was statistically significant(P<0.05).Conclusion Early goal directed therapy have significant clinical application value in septic shock patients,which can effectively improve the urine volue,mean arterial pressure,rapidly reduce blood lactate levels,shorten the time of the intensive care unit and reduce clinical mortality.It is worth promoting and applying.

关 键 词：早期集束化治疗 感染性休克 临床效果 

分 类 号：R459.7[医药卫生—急诊医学]