山莨菪碱联合乳酸钠林格液对脓毒症休克患者乳酸清除率及电解质水平的影响  

Effect of anisodamine binding lactated ringer solution on lactate clearance rate and electrolyte level in patients of septic shock

作　　者：吴世麒 许婉华[2] 莫李婵 黄汝锋 刘宏锋[2] 武钢[1] WU Shiqi;XU Wanhua;MO Lichan;HUANG Rufeng;LIU Hongfeng;WU Gang(Department of Emergency,Nanfang Hospital,Southern Medical University,Guangzhou 510515;Department of Emer-gency,Foshan First People's Hospital,Foshan Guangdong 528000,China)

机构地区：[1]南方医科大学南方医院急诊科,广州510515 [2]佛山市第一人民医院急诊科,广东佛山528000

出　　处：《新疆医科大学学报》2021年第12期1341-1345,共5页Journal of Xinjiang Medical University

基　　金：广东省医学科学技术研究项目(B2020328)。

摘　　要：目的探讨山莨菪碱联合乳酸钠林格液对脓毒症休克患者的乳酸清除率及电解质水平的影响。方法选取2019年1月-2020年12月南方医科大学南方医院急诊科收治的160例脓毒症休克患者作为研究样本,采用数字法随机分为治疗组和对照组,各80例。其中对照组男性43例,女性37例,给予常规液体复苏和抗感染治疗。治疗组男性44例,女性36例,在液体复苏和抗感染的基础上给予山莨菪碱联合治疗。主要观察两组患者0、6、12和24 h乳酸清除率和电解质水平的变化。结果治疗组治疗6、12、24 h时乳酸清除率均高于对照组,差异有统计学意义(P<0.05);治疗组治疗6、12、24 h时中心静脉压(CVP)、平均动脉压(MAP)、中心静脉血氧饱和度(ScVO;)均高于对照组,差异有统计学意义(P<0.05);治疗组治疗6、12、24 h时K;、Na;、Mg;含量与对照组相比差异无统计学意义(P>0.05),治疗组治疗12、24 h时Cl;低于对照组,差异有统计学意义(P<0.05)。结论山莨菪碱联合乳酸钠林格液治疗可以较好地改善脓毒症休克患者的微循环灌注,较快地降低乳酸水平,增加乳酸清除率,快速纠正电解质水平,从而降低患者死亡率,改善预后情况。Objective To study the effect of anisodamine binding lactated ringer solution on lactate clearance rate and electrolyte level in patients of septic shock.Methods 160 patients of septic shock treated in the hospital from January2019 to December 2020 were selected as research samples.They were randomly divided into the treatment group and the control group by digital method,with 80 cases in each group.43 males and 37 females in the control group were given routine fluid resuscitation and anti-infection treatment,while in the treatment group,44 males and 36 females were treated with anisodamine on the basis of fluid resuscitation and anti-infection.The changes of lactate clearance rate and electrolyte levels at 0 h,6 h,12 h and 24 h in the two groups were observed.Results The lactate clearance rate of the treatment group at 6 h,12 h and 24 h were significantly higher than that of the control group(P<0.05).The central venous pressure(CVP),mean arterial pressure(MAP)and central venous oxygen saturation(ScvO;)in the treatment group were significantly higher than those in the control group at 6 h,12 h and 24 h(P<0.05).There was no significant difference in the contents of K;,Na;,Mg;between the treatment group and the control group at 6 h,12 h and24 h(P>0.05),and Cl;in the treatment group was lower than that in the control group at 12 h and 24 h(P<0.05).Conclusion The treatment with anisodamine combined with lactate Ringer solution can improve the microcirculation perfusion of patients with septic shock,reduce the lactic acid level quickly,increase the lactate clearance rate and correct the electrolyte level quickly,thus it can reduce the mortality of patients and improve the prognosis.

关 键 词：山莨菪碱 乳酸钠林格液 脓毒症休克 乳酸清除率 电解质水平 

分 类 号：R559[医药卫生—血液循环系统疾病]