每搏输出量变异度在脓毒症休克液体复苏治疗中的应用

Application of stroke volume variation in the treatment of septic shock fluid resuscitation

目的研究每搏输出量变异度在脓毒症休克液体复苏治疗中的应用。方法从我院2013年2月到2015年2月收治的脓毒症休克患者中随机抽取符合本次研究要求的患者100名作为该研究对象,所有患者平均年龄均为(30±5.1)岁。以数字法随机分成观察组(50例)和对照组(50例)。运用新方法和常规方法分别对观察组和对照组进行对比治疗。观察组脓毒症休克患者用液体复苏治疗;对照组脓毒症休克患者用常规方法治疗。对比两组方法治疗脓毒症休克的疗效和对心血管系统的改善情况。结果观察组运用每搏输出量变异度测量血流动力学在各个时间上的参数分别为T1为(17.33±4.43);T2为(14.92±4.66);T3为(13.67±3.99);T4为(11.66±3.87),均明显高于对照组运用中心静脉压测量血流动力学在各个时间上的参数(5.52±0.83),(5.60±1.23),(6.71±1.10),(6.34±1.21)。差异均有统计学意义(均P<0.05)。观察组复发为12.00%(6/50),不良反应为10.00%(20/50),并发症为9.00%(18/50)显著少于对照组的22.00%(11/50),15.00%(30/50),30.00%(15/50)。差异均有统计学意义(均P<0.05)。结论每搏输出量变异度在脓毒症休克液体复苏治疗方面,应用安全可靠,效果较好。

Objective Study the application of stroke volume variation in the treatment of sepsis shock fluid resuscitation.Methods 100 cases of patients,suffered from sepsis shock and got therapy in our hospital during February 2013 to February 2013,were randomly selected as the research objects,with an average age of30 ± 5.1.And they were randomly divided into observation group（ 50 cases） and control group（ 50 cases） by digital method.The new method and conventional method were respectively applied in observe group and control group.Patients in observation group received fluid resuscitation,while the patients in control group got conventional methods.We compared the curative effect of the two methods,and the improvement effect on cardiovascular system.Results The indexes of hemodynamics of observation group measured by stroke volume variation（ T1： 17.33 ± 4.43,T2： 14.92 ± 4.66,T3： 13.67 ± 3.99,T4： 11.66 ± 3.87） were significantly higher than those in control group measured by central venous pressure measuring method（ T1： 5.52 ± 0.83,T2：5.60 ± 1.23,T3： 6.71 ± 1.10 and T4： 6.34 ± 1.21）（ all P0.05）.Recurrence rate of observation group was12.00%（ 6 /50）,adverse reaction rate was 10.00%（ 20 /50） and complication rate was 9.00%（18 /50）,which were significantly less than those in the control group（ 22.00%,11 /50; 15.00%,30 /50; 30.00%,15 /50）.Are statistically significant differences（ all P 0.05）.Conclusions The application of cardiac output in the treatment of liquid recovery of sepsis shock is safe and reliable,with good effect.