感染性休克患者血流动力学改变与预后关系的临床观察

Clinical Observation of Hemodynamic Changes Related to the Prognosis in the Septic Shock Patients

目的：研究感染性休克病人血流动力学改变与其预后的关系。方法：１９例感染性休克患者在抢救中接受肺动脉漂浮导管的临床监测，将其结果与病人的转归进行对照分析。结果：全组患者在给予容量复苏后血流动力学变化呈明显高动力状态。其主要参数变化为心脏指数增加和体循环阻力下降。这两项变化在生存组和死亡组是一致的。但在抢救后的第３天，生存组心脏指数逐渐降至正常，降低的体循环阻力指数逐渐回升；而死亡组则无任何变化。结论：心脏指数的增加与体循环阻力下降有关。因此，改善组织灌注和逆转血管瘫痪状态是决定抢救成败的关键措施。

Objective: The relationship between changes of hemodynamics and prognosis was investigated in the patients with septic shock. Methods: Hemodynamics were monitored by means of SwanGanz catheter during intensive treatment in 19 patients with septic shock. Results: The patients were all at hyperdynamic status. CI was increased but SVRI decreased in both of survival and nonsurvival groups. CI was back to normal range and SVRI recovered gradually on the third day in the survival group after having volume replacement. Both CI and SVRI on the third day were not changed in the nonsurvival group. Conclusion: To improve tissue oxygenation and corect the vascular paralysis status is the key factor for servival in septic shock patients.