不同晶胶比液体早期复苏治疗感染性休克238例疗效观察

Effects of different crystal glue- liquid ratio on early resuscitation treatment of septic shock

目的探讨不同晶胶比液体早期复苏对感染性休克的临床疗效。方法选择本院急诊科2010年6月-2014年6月救治的感染性休克238例。以第一个24小时液体晶胶比1.5和3为界,将患者分为低晶胶比组(晶胶比<1.5,82例)中晶胶比组(晶胶比1.5-3,79例)和高晶胶比组(晶胶比>3,77例),观察入院后液体复苏成功患者的第一个24小时MAP,CVP,SCVO2,机械通气率,液体复苏总量及病死率。结果入院后第一个24小时低、高晶胶比组MAP,CVP,SCVO2显著低于中晶胶比组。机械通气率、总液体量及病死率明显高于中晶胶比组。结论对感染性休克患者早期宜采用适当晶胶比的控制性液体复苏,可减轻体液潴留和提高治愈率,且采用中晶胶比的控制性液体复苏策略效果最佳。

Objective To investigate the non- isomorphous glue liquid in early resuscitation of septic shock.Methods 238 cases of septic shock were treated. The patients were divided into trestiment groups low crystal glue liquid ratio group（ratio of less than 1.5, 82 cases）, middle ratio group（ratio1.5- 3, 79 cases） and high ratio group（ratio〉3, 77 cases）.After the liquid resuscitation success to observe the first 24 hours of MAP, CVP, SCVO2, mechanical ventilation rate, total liquid recovery and mortality rate. Results The MAP, CVP and SCVO2 of low and high ratio groups were significantly lower than that of middle group. Mechanical ventilation rate, total volume of fluid and the fatality rate of low and high ratio groups were significantly higher than that of middle group. Conclusion In patients with septic shock,it should follow the appropriate crystal gel fluid resuscitation ratio.This can reduce fluid retention and improve the cure rate.The use of middle ratio fluid resuscitation strategy has the best effect.