不同晶体液早期复苏在老年感染性休克患者中的应用效果及对血流动力学参数、呼吸指标的影响  

Application effect of early resuscitation with different crystalloid fluids in elderly patients with septic shock and its influences on hemodynamic parameters and respiratory indexes

作　　者：舒新乐 侯亚儒 SHU Xinle;HOU Yaru(Hanzhong Central Hospital,Hanzhong 723000,China)

机构地区：[1]汉中市中心医院,陕西汉中723000

出　　处：《临床医学研究与实践》2024年第21期62-65,78,共5页Clinical Research and Practice

摘　　要：目的探究不同晶体液早期复苏在老年感染性休克患者中的应用效果及对血流动力学参数、呼吸指标的影响。方法选择2019年2月至2022年3月我院收治的80例老年感染性休克患者作为研究对象,以随机数字表法将其分为对照组和观察组,每组40例。在常规治疗基础上,对照组给予乳酸林格液,观察组给予羟乙基淀粉溶液。比较两组的复苏效果。结果复苏后,观察组的急性生理学及慢性健康状况评分系统(APACHEⅡ)评分低于对照组(P<0.05);观察组的机械通气时间、ICU入住时间、复苏时间均短于对照组(P<0.05)。复苏后,观察组的平均动脉血压(MAP)、心输出量(CO)、心脏指数(CI)高于对照组,每搏量变异度(SVV)低于对照组(P<0.05)。复苏后,观察组的动脉血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))高于对照组,氧减指数(ODI)、呼吸频率(RR)低于对照组(P<0.05)。观察组休克0~6 h、休克>6~12 h晶体液用量以及总用量显著少于对照组(P<0.05)。结论羟乙基淀粉溶液在老年感染性休克患者早期液体复苏治疗中的效果显著,不仅能降低晶体液用量,还能改善患者血流动力学参数及呼吸指标,缩短ICU入住时间,值得推广。Objective To explore the application effect of early resuscitation with different crystalloid fluids in elderly patients with septic shock and its influences on hemodynamic parameters and respiratory indexes.Methods A total of 80 elderly patients with septic shock admitted in our hospital from February 2019 to March 2022 were selected as the research objects.The patients were divided into control group and observation group by random number table method,with 40 cases in each group.On the basis of conventional treatment,the control group was given lactated Ringer's solution,and the observation group was given hydroxyethyl starch solution.The resuscitation effects of the two groups were compared.Results After resuscitation,the Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score of the observation group was lower than that of the control group(P<0.05);the mechanical ventilation time,ICU stay time and resuscitation time of the observation group were shorter than those of the control group(P<0.05).After resuscitation,the mean arterial pressure(MAP),cardiac output(CO)and cardiac index(CI)of the observation group were higher than those of the control group,and the stroke volume variation(SVV)was lower than that of the control group(P<0.05).After resuscitation,the arterial oxygen saturation(SaO_(2))and arterial partial pressure of oxygen(PaO_(2))in the observation group were higher than those in the control group,and the oxygen desaturation index(ODI)and respiratory rate(RR)were lower than those in the control group(P<0.05).The amount of crystalloid fluid of shock for 0-6 h,shock time>6-12 h and total amount in the observation group were significantly less than those in the control group(P<0.05).Conclusion The hydroxyethyl starch solution in the treatment of early fluid resuscitation in elderly patients with septic shock has a significant effect.It can not only reduce the amount of crystalloid fluid,but also improve the hemodynamic parameters and respiratory indexes of patients,and shorten the ICU stay time

关 键 词：晶体液 复苏 羟乙基淀粉溶液 感染性休克 老年 血流动力学参数 呼吸指标 

分 类 号：R631[医药卫生—外科学]