感染性休克复苏达标后限制补液对预后的影响

Effects of limited fluid management on patients with septic shock after early goal-directed therapy

目的探究感染性休克患者早期液体复苏达标后采取限制性液体管理与预后的关系。方法选择2004—12～2007—12入住安徽省立医院ICU的感染性休克患者56例，入选病例必须严格符合感染性休克的诊断标准，且既往无肾功能不全病史。按EGDT方案复苏，达标后随机分为限制性补液组和非限制性补液组，并采集病例相关数据。观察28d，随访完成病例36例。比较不同组间患者脱离呼吸机时间、住ICU时间、无脏器衰竭时间和病死率等。结果限制性补液组与非限制性补液组28d病死率和无脏器衰竭时间比较差异无统计学意义（P〉0．05）。但两组脱离呼吸机时间、住ICU时间比较差异有统计学意义（P〈0．05）。结论感染性休克患者在液体复苏达标后实施限制性补液可以尽早脱机，缩短住ICU时间。

Objective To investigate thc relationship between the limited fluid management and the prognosis in the patients with septic shock. Methods 56 patients with septic shock admitted to our ICU from 2004 - 12 to 2007 - 12 were studied. Patients with septic shock who had renal failure or required the dialysis prior to hospitalization were excluded. After successful fluid resuscitation by early goal - directed therapy, patients were randomly divided into two groups （ limited fluid input and unlimited fluid input ） to compare some data including mortality, the clays of weaning respirator, the clays in ICU and the days without organ failure within 28 days. Result There were no differences in the mortality and the days without organs failure between two groups （ P 〉 0.05 ） , but there were obvious differences in the days of weaning respirator and the days in 1CU （ P 〈 0.05 ）. Conclusion It is reasonable choice to carry out limited fluid management to wean respirator quickly and shorten the days in ICU for patients with septic shock after early goal -directed therapy.