不同液体对感染性休克早期液体复苏临床观察.docxVIP

不同液体对感染性休克早期液体复苏临床观察 doi: 10. 3969/j. issn. 1007-614x. 2014. 3. 40 摘要目的：探讨不同液体对感染性休克早期液体复苏 的临床疗效。方法：收治感染性休克患者80例，随机分成 NS组、万汶组、高钠组、霍姆组，各20例，分别给予盐水、 軽乙基淀粉、3%高渗氯化钠、高渗氯化钠轻乙基淀粉进行复 苏。结果：四组复苏后不同时间点的比较：四组随着复苏时 间的延长，MAP和CVP逐渐升高，HR逐渐降低，在复苏1小 时霍姆组与其他3组MAP、CVP、HR比较差异有统计学意义 (P0. 05),但与高钠组和NS组比较差异有统计学意义 (P0. 05)o结论：高渗氯化钠轻乙基淀粉是感染性休克早期 液体复苏的首选复苏液。 关键词感染性休克液体复苏临床观察 Clinical observation of different liquids on early fluid resuscitation of septic shock Wen Xiaoyan ICU the ninth people s hospital in Zhengzhou City, Henan Province, 450000 Abstract Objective : To discuss the clinical efficacy of different liquids on early fluid resuscitation of septic shock?Methods : To admit 80 cases of patients with septic shock from October 2012 to September 2013.There were randomly divided into NS group, voluven group, high sodium group, holm group, each 20 cases, were given saline, hydroxyethyl st arch, 3% sodium chloride solution, hypertonic sodium chloride hydroxyethyl starch recovery. ResuIts： Comparison of the 4 groups at different time points after resuscitation： four groups of patients with prolonged recovery time, MAP and CVP increased, HR gradually decreased. In 1 hour after resuscitation, compare MAP, CVP, HR of Holm group and other three groups, there had significant difference (P0.05), but compare with high sodium group and NS group, there were significantly different ( P0.05 ) . Conclusion : Hypertonic sodium chloride hydroxyethyl starch is the preferred recovery liquid in the treatment of septic shock in early fluid resuscitation. Key words Septic shock ； Fluid resuscitation ； Clinical observation 感染性休克是病原微生物侵入机体导致炎性介质大量 释放而引起的急性器官功能损害，又称为中毒性休克、脓毒 性休克、内毒素性休克，病死率较高[1, 2]o及时的液体复 苏是抢救感染性休克患者的首要治疗措施，目前临床上选择 的复苏液体种类有较大争议，为探讨不同液体对感染性休克 早期液体复苏的临床疗效，收治80例感染性休克患者进行 回顾性分析，现报告如下。 资料与方法 2012年10月-2013年9月收治感染性休克患者80例， 随机分成NS组、万汶组、高钠组、霍姆组各20例，其中NS 组男 11 例，女 9 例，年龄(40. 9±14. 8)岁，MAP(52.8±5.6) mmllg, CVP (4. 7±0. 8) mmHg, HR (122.7±13.4)次/分； 万汶组男12例，女8例，年龄(40.7±14. 7)岁，MAP (52. 6±5. 7)mmHg, CVP(4. 8±0