艾司洛尔+体外膜肺氧合治疗重症脓毒症的临床疗效分析  

Clinical analysis of esmolol combined with extracorporeal membrane oxygenation in the treatment of severe sepsis

作　　者：陈博文 吴金海 赵菊馨 孙航 刘冬 Chen Bowen;Wu Jinhai;Zhao Juxin;Sun Hang;Liu Dong(Nanyang Key Laboratory of Sepsis Transformation,Henan University Affiliated Nanyang First People′s Hospital,Henan 473000,China)

机构地区：[1]河南大学附属南阳市第一人民医院南阳市脓毒症转化重点实验室,473000

出　　处：《山西医药杂志》2025年第2期94-98,共5页Shanxi Medical Journal

基　　金：河南省南阳市科学技术局(23JCQY1008)。

摘　　要：目的探讨成人难治性脓毒症休克伴呼吸衰竭治疗中,艾司洛尔与体外膜肺氧合(ECMO)联合运用的临床疗效。方法本研究采用随机对照试验设计,将我院符合纳入标准的100例难治性脓毒症休克伴呼吸衰竭患者随机分为观察组和对照组各50例。对照组接受ECMO治疗,而观察组在ECMO治疗基础上加用艾司洛尔。研究过程中,详细记录2组患者的生命体征、炎症反应指标、器官功能指标等,并对比2组患者序贯器官衰竭检测评分、不良事件发生率、成功脱机康复率等预后指标。结果治疗后,与对照组相比,观察组患者心率、心搏出量明显较低,平均动脉压(MAP)明显较高,C-反应蛋白、白细胞计数、降钙素原明显较低,动脉血氧含量、氧合指数(P/F)明显较高,呼吸指数明显较低,急性生理、慢性健康评分Ⅱ以及序贯器官衰竭检测评分评分明显较低;不良事件发生率较低(P<0.05)。结论艾司洛尔联合ECMO治疗重症脓毒症具有较好的临床疗效,能够显著改善患者的生命体征、减轻炎症反应、保护器官功能,发生的不良事件较少。Objective To investigate the clinical efficacy of esmolol combined with extracorporeal membrane oxygenation(ECMO)in the treatment of adult refractory septic shock with respiratory failure.Methods In this study,100 patients with refractory septic shock with respiratory failure in our hospital were randomly divided into an observation group(n=50)and a control group(n=50).The control group received ECMO treatment,while the observation group received esmolol on the basis of ECMO treatment.In the course of the study,the vital signs,inflammatory reaction index and organ function index of the two groups were recorded in detail,and the prognostic indexes such as sequential organ failure score,incidence of adverse events and successful weaning recovery rate were compared between the two groups.Results After treatment,compared with the control group,the patients in the observation group had significantly lower heart rate,cardiac output,higher mean arterial pressure(MAP),lower C-reactive protein,white blood cell count,procalcitonin,higher arterial oxygen content,higher oxygenation index and lower respiratory index,and lower acute physiology,chronic health scoreⅡand sequential organ failure score.The incidence of adverse events was lower(P<0.05).Conclusion Esmolol combined with ECMO has good clinical efficacy in the treatment of severe sepsis,which can significantly improve the vital signs of patients,reduce inflammatory reactions,protect organ function,and have fewer adverse events.

关 键 词：脓毒症 成年人 呼吸功能不全 艾司洛尔 体外膜肺氧合 

分 类 号：R459.7[医药卫生—急诊医学]