基于SSV和乳酸清除率的改良早期目标导向治疗对脓毒症低灌注患者脑氧代谢、S100β蛋白的影响  

Effects of modified early target-directed therapy based on SSV and lactat e clearance on cerebral oxygen metabolism and S100βprotein in patients with sepsis hypoperfus ion

作　　者：徐圣君[1] 梁晓丽 XU Shengjun;LIANG Xiaoli(Department of Geriatrics,the Fifth People’s Hospital of Chengdu,the Fi fth People’s Hospital Affiliated to Chengdu University of Traditional Chinese Medicine/The Second Clinical Medical Colleg e,Chengdu 611130)

机构地区：[1]成都市第五人民医院,成都中医药大学附属第五人民医院/第二临床医学院老年医学科,四川成都611130

出　　处：《当代医药论丛》2023年第2期87-90,共4页

基　　金：四川省医学科研课题计划(编号:S20089)。

摘　　要：目的:分析基于每搏量变异(SSV)和乳酸清除率(LCR)的改良早期目标导向(EGDT)治疗对脓毒症低灌注患者脑氧代谢、中枢神经特异蛋白(S100β蛋白)的影响。方法:以成都市第五人民医院2021年4月至2022年4月收治的100例脓毒症低灌注患者为例,随机法分为对照组和观察组(各50例)。对照组接受常规治疗,观察组另加用基于SSV和LCR的改良EGDT治疗,比较两组患者的治疗效果。结果:在液体复苏6h(T1)、液体复苏24h(T2),两组的心率(HR)、心指数(CI)、乳酸、血红蛋白(Hb)、神经元特异性烯醇化酶(NSE)、S100β蛋白水平相比,差异显著(P<0.05)。观察组的住院时间、ICU住院时间均短于对照组,谵妄发生率(4.00%)低于对照组的18.00%,28d死亡率(0.00%)低于对照组的12.00%,差异显著(P<0.05)。结论:对脓毒症低灌注患者进行基于SSV和LCR的改良EGDT治疗的效果较好,可有效避免不合理液体负荷引起的组织水肿,在改善患者脑灌注方面具有一定优势。Objective:To analyze the effects of modified early target oriented(EGDT)therapy based on stroke volume variation(SSV)and lactate clearance(LCR)on brain oxygen metabolism and central nervous specific protein(S100βprotein)in patients with sepsis hypoperfusion.Methods:100 patients with sepsis hypoperfusion admitted to Chengdu Fifth People’s Hospital from April 2021 to April 2022 were randomly divided into control group and observation group(50 cases each).The control group received conventional treatment,and the observation group was additionally treated with modified EGDT based on SSV and LCR to compare the therapeutic effects of the two groups.Results:At 6h(T1)and 24h(T2)of liquid resuscitation,the heart rate(HR),heart index(CI),lactic acid,hemoglobin(Hb),neuron specific enolase(NSE)and S100βprotein levels of the two groups were significantly different(P<0.05).The length of hospital stay and ICU stay in the observation group were shorter than those in the control group,the incidence of delirium(4.00%)was lower than that in the control group(18.00%),and the 28d mortality(0.00%)was lower than that in the control group(12.00%),the differences were significant(P<0.05).Conclusions:The modified EGDT therapy based on SSV and LCR has good effect on patients with sepsis hypoperfusion,which can effectively avoid tissue edema caused by unreasonable fluid load,and has certain advantages in improving patients’brain perfusion.

关 键 词：每搏量变异 乳酸清除率 改良早期目标导向 脓毒症 低灌注 脑氧代谢 

分 类 号：R631[医药卫生—外科学]