静脉泵入艾司洛尔辅助液体复苏治疗脓毒症休克的效果研究  

Effect of intravenous infusion of esmolol assisted fluid resuscitation in septic shock

作　　者：刘婉 陈晓[1] 王海玲[1] 李莹莹 Liu Wan;Chen Xiao;Wang Hailing;Li Yingying(Department of Critical Care Medicine,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院重症医学科,南阳473000

出　　处：《中国临床实用医学》2024年第2期19-24,共6页China Clinical Practical Medicine

基　　金：河南省医学科技攻关项目(LHGJ202103015)。

摘　　要：目的探讨静脉泵入艾司洛尔辅助液体复苏治疗脓毒症休克的效果。方法本研究为前瞻性随机对照研究,选取2021年1月至2023年6月南阳医学高等专科学校第一附属医院重症医学科收治的101例脓毒症休克患者,男61例,女40例,年龄(55.69±5.21)岁,年龄范围为48~62岁。采用电脑分组法将患者随机分为常规组(n=50)与联合组(n=51)。常规组予以常规治疗+液体复苏治疗,联合组在常规组治疗的基础上经静脉泵入艾司洛尔。比较两组患者的恢复情况、基础体征、氧合功能、血清学指标及预后情况。结果联合组患者的意识恢复时间、机械通气时间、ICU转出时间、住院时间[(10.77±2.25)h、(8.32±1.25)d、(10.44±2.28)d、(14.46±3.25)d]低于常规组[(12.49±3.41)h、(10.36±2.31)d、(12.77±3.13)d、(16.65±3.42)d];联合组患者治疗后的心率[(63.44±10.26)次/分]低于常规组[(68.26±10.45)次/分],平均动脉压、血氧饱和度[(71.22±10.41)mmHg、(98.66±1.15)%,1 mmHg=0.133 kPa]高于常规组[(66.39±10.44)mmHg、(95.27±1.14)%];联合组患者治疗后的动脉氧分压、动脉氧气含量、氧合指数[(110.25±20.46)mmHg、(75.25±10.23)%、(390.27±30.44)mmHg]高于常规组[(98.25±20.33)mmHg、(70.41±10.29)%、(368.24±30.33)mmHg];联合组患者治疗后的血清乳酸、内皮细胞特异分子-1、缺氧诱导因子-1α[(1.88±0.63)mmol/L、(35.45±5.28)ng/ml、(1325.45±100.47)ng/L]低于常规组[(2.25±0.76)mmol/L、(38.66±5.37)ng/ml、(1433.76±100.47)ng/L];联合组患者治疗后的序贯性脏器功能衰竭评分、急性生理学和慢性健康状况评价[(8.25±1.33)分、(17.33±4.19)分]低于常规组[(10.46±2.88)分、(20.49±4.12)分],差异均有统计学意义(P<0.05)。结论静脉泵入艾司洛尔联合液体复苏能加快脓毒症休克患者的康复进程,能稳定患者基础体征、氧合功能,促进血清学相关指标恢复。Objective To explore the effect of intravenous infusion of esmolol assisted fluid resuscitation in septic shock.Methods This study was a prospective randomized controlled study,a total of 101 patients with septic shock admitted to the department of cntreal care medicine of the First Affiliated Hospital of Nanyang Medical College from January 2021 to June 2023.There were 61 males and 40 females,aged(55.69±5.21)years old,ranging from 48 to 62 years old.All patients were randomly divided into conventional group(n=50)and combination group(n=51)by using computer grouping method.The conventional group received conventional treatment and fluid resuscitation treatment,while the combination group received intravenous infusion of esmolol on the basis of conventional group treatment.Compare the rehabilitation status,basic physical signs,oxygenation function,serological indicators,and prognosis between two groups of patients.Results The consciousness recovery time,mechanical ventilation time,ICU transfer time,and hospitalization time of the combination group[(10.77±2.25)min,(8.32±1.25)d,(10.44±2.28)d,(14.46±3.25)d]were lower than those in the conventional group[(12.49±3.41)min,(10.36±2.31)d,(12.77±3.13)d,(16.65±3.42)d];the heart rate of the combination group[(63.44±10.26)times/min]was lower than that in the conventional group[(68.26±10.45)times/min],while mean arterial pressure and SaO_(2)[(71.22±10.41)mmHg,(98.66±1.15)%,1 mmHg=0.133 kPa]were higher than those in the conventional group[(66.39±10.44)mmHg,(95.27±1.14)%].The PO_(2),CaO_(2),and oxygenation index of the combination group[(110.25±20.46)mmHg,(75.25±10.23)%,(390.27±30.44)mmHg]were higher than those in the conventional group[(98.25±20.33)mmHg,(70.41±10.29)%,(368.24±30.33)mmHg];the values of lactate dehydrogenase,endothelial cell specific molecule-1,hypoxia inducible factor-1 in the combination group[(1.88±0.63)mmol/L,(35.45±5.28)μg/L,and(1325.45±100.47)ng/L]were lower than those in the conventional group[(2.25±0.76)mmol/L,(38.66±5.37)μg/L,

关 键 词：脓毒症 休克 艾司洛尔 液体复苏 氧合功能 

分 类 号：R459.7[医药卫生—急诊医学]