不同液体复苏对脓毒症休克患者血流动力学状态的影响研究  

Study on the Effect of Different Fluid Resuscitation on Hemodynamic Status in Septic Shock Patients

作　　者：高翔 GAO Xiang(Luodian Country Chinese Medicine Hospital of Guizhou Province,Luodian,Guizhou 550100)

机构地区：[1]贵州省罗甸县中医医院,贵州罗甸550100

出　　处：《科技与健康》2023年第5期65-68,共4页Technology and Health

摘　　要：为研究不同液体复苏对脓毒症休克患者血流动力学状态的影响,选取2020年1月—2022年12月在贵州省罗甸县中医医院进行治疗的84例脓毒症休克患者作为观察对象,采用计算机编号随机分组法将其分为4组(每组21例),分别予以差异化的复苏液进行治疗。其中,甲组选用羟乙基淀粉溶液,乙组选用生理盐水,丙组选用乳酸林格液,丁组选用醋酸钠钾镁钙葡萄糖注射液。比较4组患者复苏6h后达标率、危重病情评价(APACHEⅡ)评分、血流动力学、病死率。结果显示,甲、乙、丙、丁4组患者复苏6h后达标率差异无统计学意义(P>0.05)。复苏后14d,丁组的病死率明显低于甲、乙组(P<0.05)。丙丁两组复苏后的APACHEⅡ评分与复苏前相比明显降低,且丁组低于丙组(P<0.05)。丁组复苏后的HR水平低于甲、乙、丙三组,CI、MAP水平高于甲、乙、丙三组(P<0.05)。研究发现,醋酸钠钾镁钙葡萄糖注射液能够降低脓毒症休克患者病死率及病情危重程度,改善其血流动力学状态。84 patients with septic shock who were treated in Luodian Country Chinese Medicine Hospital of Guizhou Province from January 2020 to December 2022 were selected as observation objects.They were randomly divided into 4 groups(21 cases in each group)using computer numbering and treated with differentiated resuscitation fluids.Among them,Group A uses hydroxyethyl starch solution,Group B uses physiological saline,Group C uses lactate Ringer solution,and Group D uses sodium acetate potassium magnesium calcium glucose injection.Compare the compliance rate,critical illness assessment(APACHE II)score,hemodynamics,and mortality rate among the four groups after 6 hours of resuscitation.The results showed that there was no statistically significant difference in the compliance rate among the four groups of patients A,B,C,and D after 6 hours of resuscitation(P>0.05).14 days after resuscitation,the mortality rate of group D was significantly lower than that of groups A and B(P<0.05).The APACHE II scores of the two groups after resuscitation were significantly lower than before,and the D group was lower than the C group(P<0.05).The HR level of group D after resuscitation was lower than that of group A,B,and C,while the CI and MAP levels were higher than those of group A,B,and C(P<0.05).Research has found that sodium acetate potassium magnesium calcium glucose injection can reduce the mortality rate and severity of septic shock patients,and improve their hemodynamic status.

关 键 词：脓毒症休克 液体复苏 血流动力学 APACHEⅡ评分 病死率 

分 类 号：R459.7[医药卫生—急诊医学]