液体负平衡应用于感染性休克患者对APACHEII评分的影响  

EFFECT OF FLUID NEGATIVE BALANCE ON APACHEII SCORE IN PATIENTS WITH SEPTIC SHOCK

作　　者：郭旭 王磊 GUO Xu;WANG Lei(Department of Emergency Medicine,Nanyang Central Hospital,Nanyang 473000 China)

机构地区：[1]南阳市中心医院急诊科,河南南阳473000 [2]南阳市中心医院血液净化科,河南南阳473000

出　　处：《疾病监测与控制》2022年第1期1-3,18,共4页Journal of Diseases Monitor and Control

摘　　要：目的:探讨液体负平衡对感染性休克患者急性生理学与慢性健康状态(APACHEII)评分的影响。方法:选取2018-01~2020-01本院收治的92例感染性休克患者,按不同液体管理模式分为常规组(采用液体平衡管理模式)和研究组(采用液体负平衡管理模式),各46例。对比分析两组患者心肺功能及APACHEII评分以及不良反应。结果:管理前两组全心舒张末期容量指数(GED-CVI)和血管外肺水指数(EVLWI)比较差异无统计学意义(P>0.05),管理后两组GED-CVI、EVLWI水平均增加(P<0.05),研究组上述水平高于常规组(P<0.05);研究组和常规组均完成了管理计划,两组管理前APACHEII评分比较,差异均无统计学意义(P>0.05),管理后均低于管理前(P<0.05),管理后研究组低于常规组(P<0.05);两组均未见明显不良反应发生(P>0.05)。结论:液体负平衡应用于感染性休克患者,可改善心肺功能指标,降低APACHEII评分,可作为临床管理及防控的参考指标。Objective:To investigate the effect of fluid negative balance on acute physiology and chronic health status(APACHEII)scores in patients with septic shock.Methods:From January 2018 to January 2020,92 patients with septic shock were selected.According to different liquid management modes,46 cases were divided into routine group(using liquid balance)and study group(using liquid negative balance management mode).The cardiopulmonary function,APACHEII score and adverse reactions of the two groups were compared and analyzed.Results:There was no significant difference in total cardiac end diastolic volume index(GED-CVI)and extravascular lung water index(EVLWI)between the two groups before management(P>0.05).After management,GED-CVI and EVLWI increased on average(P<0.05).The above levels in the study group were higher than those in the routine group(P<0.05);Both the study group and the routine group completed the management plan.There was no significant difference in APACHEII score between the two groups before management(P>0.05),which was lower than that before management(P<0.05),and that in the study group after management was lower than that in the routine group(P<0.05);There were no significant adverse reactions in both groups(P<0.05).Conclusions:The application of negative fluid balance in patients with septic shock can improve the indexes of cardiopulmonary function and reduce the APACHEII score.It can be used as a reference index for clinical management and prevention and control.

关 键 词：感染性休克 腹腔感染 血源性感染 液体负平衡管理 

分 类 号：R715.4[医药卫生—妇产科学]