循环监测在脓毒症病人液体复苏中的应用

    Application of circulatory monitoring in fluid resuscitation of patients with sepsis

    • 摘要:
      目的探讨循环监测在脓毒症病人液体复苏中的应用价值。
      方法选择脓毒症病人150例作为研究对象,根据随机数字表法把病人分为观察组与对照组,各75例。对照组给予传统液体复苏治疗,观察组给予循环监测的液体复苏治疗,检测病人血乳酸、乳酸清除率和心排血量(CO)与预后情况。
      结果2组治疗3 h后血乳酸值低于治疗前,乳酸清除率和CO高于治疗前(P < 0.01),且治疗3 h后观察组血乳酸与乳酸清除率及CO与对照组比较差异均有统计学意义(P < 0.01)。2组治疗7 d后的SOFA评分和APACHE Ⅱ评分均低于治疗前(P < 0.01),且观察组低于对照组(P < 0.01)。治疗28 d后,观察组的急性肾衰竭、多器官功能障碍及病死率均低于对照组(P < 0.01)。
      结论循环监测在脓毒症病人液体复苏中应用能改善心肺功能,持续促进改善病人的预后。

       

      Abstract:
      ObjectiveTo explore the application value of circulatory monitoring in fluid resuscitation of patients with sepsis.
      MethodsOne hundred and fifty cases of patients with sepsis in our hospital were selected as the research objects, and the patients were divided into observation group (n=75) and control group (n=75) according to the random number table method.The control group were given traditional fluid resuscitation therapy and the observation group were given fluid resuscitation therapy based on circulatory monitoring.The blood lactic acid, lactic acid clearance and cardiac output (CO) and prognosis of all cases were recorded.
      ResultsAfter 3 hours of treatment, the blood lactic acid value of the two groups were lower than before treatment (P < 0.01).The lactic acid clearance rate and CO were higher than before treatment (P < 0.01).The SOFA score and APACHE Ⅱ score of the two groups after 7 days of treatment were lower than that of the baseline (P < 0.01) and the observation group were lower than the control group (P < 0.01).After 28 days of treatment, the acute renal failure, multiple organ dysfunction and mortality of the observation group were lower than those of the control group (P < 0.01).
      ConclusionsThe application of circulatory monitoring in fluid resuscitation of sepsis patients can improve cardiopulmonary function and continue to improve the prognosis of patients.

       

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