人工胶体液和晶体液感染性休克液体复苏对比研究  

Comparative Study on Fluid Resuscitation in Septic Shock Caused by Artificial Colloid and Crystal Fluid

作　　者：黄浩[1] 郭永明[1] 万展鸥 张璐 林湘 纪云航 HUANG Hao;GUO Yong-ming;WAN Zhan-ou;ZHANG Lu;LIN Xiang;JI Yun-hang(Department of Emergency Medicine,Fujian Provincial Hospital North,Fujian Provincial Geriatric Hospital,Fuzhou 350003,Fujian Province,China)

机构地区：[1]福建省立医院北院福建省老年医院急诊医学科,福建福州350003

出　　处：《罕少疾病杂志》2024年第10期136-137,共2页Journal of Rare and Uncommon Diseases

摘　　要：目的回顾性对比分析人工胶体液和晶体液在容量反应性感染性休克患者液体复苏的疗效及不良反应。方法选取2013年1月至2020年6月于我院ICU住院138例脓毒症伴感染性休克患者。分为羟乙基淀粉氯化钠扩容(A)组和复方氯化钠注射液扩容(B)组。比较两组治疗72小时后,电解质、肌酐、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)、动脉血气分析、PICCO血流动力学监测心脏指数(CI)、心搏指数(SVI)、血管外肺水(EVLW)、肺血管通透性指数(PVPI)、全心舒张末容积指数(GEDI)、中心静脉压(CVP)、水肿情况。结果A组GEDI较B组增加,A组肌酐、乳酸、EVLW、PVPI、水肿较B组少,剩余碱较B组更高,电解质、APTT、PT、CI、SVI、CVP两组没有显著差异。结论感染性休克患者液体复苏,使用羟乙基淀粉氯化钠扩容较晶体液显著改善循环血容量,减少毛细血管渗漏、血管外肺水,减少水肿发生及肾损害,更能显著改善代酸和降低乳酸水平,不增加对凝血功能、电解质及心功能影响。Objective Retrospective comparative analysis of the efficacy and adverse reactions of artificial colloid solution and crystal solution in fluid resuscitation of patients with volume responsive septic shock.Methods Select 138 patients with sepsis and septic shock hospitalized in our hospital's ICU from January 2013 to June 2020.Divided into hydroxyethyl starch sodium chloride expansion(A)group and compound sodium chloride injection expansion(B)group.After 72 hours of treatment,electrolyte,creatinine,activated partial thrombin time(APTT),Prothrombin time(PT),arterial blood gas analysis,PICCO hemodynamic monitoring cardiac index(CI),stroke index(SVI),extravascular lung water(EVLW),pulmonary vascular permeability index(PVPI),global end diastolic volume index(GEDI),Central venous pressure(CVP),and edema were compared between the two groups.Results GEDI in Group A increased compared to Group B,while creatinine,lactate,EVLW,PVPI,and edema were less in Group A compared to Group B.The remaining base was higher in Group B,and there was no significant difference in electrolytes,APTT,PT,CI,SVI,and CVP between the two groups.Conclusion The fluid resuscitation of patients with septic shock,using hydroxyethyl starch sodium chloride to expand the volume significantly improves the circulating blood volume,reduces capillary leakage,extravascular lung water,reduces edema and kidney damage,and can significantly improve acid replacement and reduce the level of lactic acid,without increasing the impact on blood coagulation function,electrolyte and cardiac function.

关 键 词：羟乙基淀粉氯化钠注射液 晶体液 感染性休克 液体复苏 

分 类 号：R631.4[医药卫生—外科学]