山莨菪碱联合液体复苏对ICU脓毒症休克患者微循环和主要脏器功能的影响  

The Effects of Anisodamine Combined with Fluid Resuscitation on Major Organ Function and Microcirculation in ICU Septic Shock Patients

作　　者：周晓颖 许剑锋 谢玉华 周警 ZHOU Xiaoying;XU Jianfeng;XIE Yuhua(Department of Critical Care Medicine,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou City,Fujian Province 363000)

机构地区：[1]福建医科大学附属漳州市医院重症医学科,福建省漳州市363000

出　　处：《医学理论与实践》2024年第16期2711-2714,2735,共5页The Journal of Medical Theory and Practice

摘　　要：目的:探究山莨菪碱联合液体复苏对重症监护室(ICU)脓毒症休克患者微循环和主要脏器功能的影响。方法:选择2020年5月—2023年5月在我院ICU收治的脓毒症休克患者88例为研究对象,并按治疗方式的不同分为研究组48例、对照组40例。对照组应用液体复苏及其他抗休克治疗,研究组在对照组的基础上联合山莨菪碱进行治疗,比较两组的电解质水平、微循环指标、心肺损伤指标、序贯器官衰竭评分(SOFA)、急性生理和慢性健康状况评分(APACHEⅡ)、并发症的变化情况。结果:两组治疗前及治疗6h、12h后的钾离子(K^(+))、氯离子(Cl^(-))、钠离子(Na^(+))水平相比,均无统计学差异(P>0.05)。治疗6h、12h后,两组的氧耗(VO_(2))、氧输送(DO_(2))、乳酸清除率、中心静脉血氧饱和度(ScvO_(2))、氧合指数(OI)水平有所升高,血乳酸水平有所降低,且研究组较对照组改善良好(P<0.05)。治疗后APACHEⅡ评分、SOFA评分降低(P<0.05);研究组并发症总发生率明显低于对照组(P<0.05)。结论:对ICU脓毒症休克患者实施山莨菪碱联合液体复苏予以治疗,可有助于改善患者体内的微循环,降低血乳酸及提高乳酸清除率,使并发症发生概率下降,为临床治疗该病提供了参考。Objective:To explore the effects of anisodamine combined with fluid resuscitation on microcirculation and main organ functions of septic shock patients in ICU.Methods:88 patients with septic shock admitted to the ICU of our hospital from May 2020 to May 2023 were selected as the research subjects,and they were divided into a study group of 48 cases and a control group of 40 cases according to different treatment methods.The control group received fluid resuscitation and other anti shock treatments,while the study group received treatment with a combination of anisodamine on the basis of the control group.The electrolyte levels,microcirculation indicators,cardiopulmonary injury indicators,sequential organ failure score(SOFA),acute physiological and chronic health status score(APACHEⅡ),and changes in complications were compared between the two groups.Results:There was no statistically significant difference in the levels of potassium ions(K^(+)),chloride ions(Cl^(-)),and sodium ions(Na^(+))between the two groups before and 6 and 12 hours after treatment(P>0.05).After 6 and 12 hours of treatment,the oxygen consumption(VO_(2)),oxygen delivery(DO_(2)),lactate clearance rate,central venous oxygen saturation(ScvO_(2)),and oxygenation index(OI)levels of both groups increased,while blood lactate levels decreased.The study group showed better improvement than the control group(P<0.05).After treatment,the APACHEⅡscore and SOFA score decreased(P<0.05).The probability of complications in the study group was significantly lower than that in the control group(P<0.05).Conclusion:Treating septic shock patients in ICU with anisodamine combined with fluid resuscitation can help to improve microcirculation,reduce blood lactic acid and increase lactate clearance rate,and reduce the incidence of complications,which provides a reference for clinical treatment of this disease.

关 键 词：脓毒症休克 山莨菪碱 液体复苏 电解质 微循环 

分 类 号：R631[医药卫生—外科学]