羟乙基淀粉胶体复苏方案在感染性休克早期复苏中的应用

Clinical efficacy of hydroxyethyl starch gel resuscitation treatment on septic shock

目的探讨羟乙基淀粉胶体复苏方案在感染性休克早期复苏中的应用效果。方法将100例感染性休克患者随机分为胶体组和晶体组,每组50例。胶体组患者给予羟乙基淀粉胶体复苏,晶体组患者给予乳酸林格氏液复苏。比较两组患者的凝血指标、血清乳酸水平、炎症因子水平指标、危重症评分变化以及死亡率。结果治疗前后两组患者的凝血指标比较差异均无统计学意义(P>0.05)。治疗前两组患者的血清乳酸水平和炎症因子水平比较差异均无统计学意义(P>0.05)。治疗后胶体组患者的血清乳酸水平和炎症水平显著低于晶体组(P<0.01)。治疗后胶体组患者的危重症评分和死亡率均低于晶体组(P<0.01或P<0.05)。结论羟乙基淀粉胶体复苏方案运用于感染性休克早期复苏显著优于乳酸林格氏液复苏方案,具有临床推广价值。

Objective To study the clinical effects of hydroxyethyl starch gel resuscitation treatment on septic shock. Methods A total of 100 septic shock patients were randomly divided into colloid group and crystalloids group, with 50 patients in each group. Patients in colloid group were treated with hydroxyethyl starch gel resuscitation treatment and patients in crystalloids group were treated with Lactated Ringer＇s solution resuscitation treatment. The coagulation index, serum lactate level, serum inflammatory cytokines, APACHE Ⅱ score and death rate between two groups were compared. Results There was no statistically significant difference between the coagulation index of two groups before and after treatment（P〉0.05）. Before treatment there was no statistically significant difference of serum lactate level and inflammatory cytokines between two groups（P〉0.05）. After treatment, both of the serum lactate level and inflammatory cytokines in colloid group were significantly lower than those in crystalloids group（P〈0.01）. After treatment, the APACHEⅡ score and death rate in colloid group were significantly lower than those in crystalloids group（P〈0.01, P〈0.05）. Conclusion Hydroxyethyl starch gel resuscitation treatment has a better clinical efficacy on septic shock than that of the Lactated Ringer＇s solution resuscitation treatment, which makes it worth for clinical application.