去甲肾上腺素联合重症超声指导下液体复苏治疗老年脓毒性休克的效果及对血流动力学、预后的影响  

Effect of Norepinephrine Combined with Severe Ultrasound-Guided Fluid Resuscitation on Elderly Septic Shock and Its Influence on Hemodynamics and Prognosis

作　　者：赵燕[1] 何瑾[1] 朱宾仁 ZHAO Yan;HE Jin;ZHU Binren(Department of Emergency,Zigong Fourth People's Hospital,Sichuan Province,Zigong 643000,Sichuan,China)

机构地区：[1]四川省自贡市第四人民医院急诊科,四川自贡643000

出　　处：《系统医学》2025年第5期59-62,共4页Systems Medicine

摘　　要：目的研究去甲肾上腺素联合重症超声(critical care ultrasound,CCUS)指导下液体复苏在老年脓毒性休克患者中的治疗效果及对血流动力学、预后的影响。方法非随机选取四川省自贡市第四人民医院于2022年5月—2023年8月收治的90例脓毒性休克老年患者为研究对象。根据治疗方法不同分为对照组与研究组,各45例。对照组在去甲肾上腺素治疗基础上给予早期目标导向治疗(early goal-directed therapy,EGDT),研究组在去甲肾上腺素治疗基础上给予CCUS指导下液体复苏治疗。对比两组临床疗效、血流动力学指标及预后情况。结果研究组治疗总有效率为95.56%(43/45),高于对照组的71.11%(32/45),差异有统计学意义(χ^(2)=9.680,P<0.05)。研究组平均动脉压及中心动脉压均高于对照组,心率、序贯器官衰竭估计评分与急性生理与慢性健康评分低于对照组患者,差异有统计学意义(P均<0.05)。结论在脓毒性休克老年患者的治疗中应用CCUS指导下液体复苏治疗,相较于应用目标导向治疗有更好的临床疗效,能够改善患者血流动力学及预后。Objective To study the therapeutic effect of fluid resuscitation guided by norepinephrine combined with critical care ultrasound(CCUS)in elderly patients with septic shock and its effect on hemodynamics and prognosis.Methods A total of ninety elderly patients with septic shock admitted to the Zigong Fourth People's Hospital,Sichuan Province from May 2022 to August 2023 were non-randomly selected as the study objects.According to different treatment methods,they were divided into control group and study group,forty-five cases in each group.The control group was given early goal-directed therapy(EGDT)on the basis of norepinephrine therapy,while the study group was given CCUS-guided liquid resuscitation therapy on the basis of norepinephrine therapy.The clinical efficacy,hemodynamic indexes and prognosis of the two groups were compared.Results The total effective rate of the study group was 95.56%(43/45),which was higher than 71.11%(32/45)of the control group,the difference was statistically significant(χ^(2)=9.680,P<0.05).The mean arterial pressure and central arterial pressure of the study group were higher than those of the control group,and the heart rate,estimated sequential organ failure score and acute physiological and chronic health score were lower than those of the control group,the differences were statistically significant(all P<0.05).Conclusion The application of CCUS-guided fluid resuscitation therapy in the treatment of elderly patients with septic shock has better clinical efficacy and can improve the hemodynamics and prognosis of patients compared with the application of target-directed therapy.

关 键 词：去甲肾上腺素 液体复苏 重症医学 脓毒性休克 

分 类 号：R4[医药卫生—临床医学]