不同换泵方案对感染性休克患者血压的影响分析

Influence of pump change modes on blood pressure of patients with septic shock

目的探讨感染性休克患者采用双泵双通路和双泵单通路对于血管活性药物注射泵更换期间的血压变化。方法选取2015年1月-2016年12月医院住院治疗的感染性休克患者112例,采用随机数字表法将112例患者随机分为双通路组和单通路组,每组各56例;两组患者均给予常规对症治疗和液体复苏,双通路组和单通路组分别采用双泵双通路和双泵单通路换泵方式;采集患者标本,进行菌株鉴定;记录患者血流动力学基本稳定时的收缩压、血压波动最大幅度和血压波动时间;记录两组治疗期间不良反应发生情况。结果双通路组56例患者分离出病原菌62株,其中革兰阴性菌43株占69.35%,革兰阳性菌16株占25.81%,真菌3株占4.84%,单通路组56例患者分离出病原菌64株,其中革兰阴性菌41株占64.06%,革兰阳性菌19株占29.69%,真菌4株占6.25%,双通路组和单通路组病原菌构成比较差异无统计学意义;双通路组和单通路组初始收缩压比较差异无统计学意义;单通路组血压波动最大幅度和血压波动时间均显著低于双通路组(P<0.01);双通路组和单通路组不良反应发生率比较差异无统计学意义。结论与双泵双通路换泵方式相比,双泵单通路换泵方式可降低感染性休克患者血压波动,可以考虑作为血管活性药物的标准换泵方式。

OBJECTIVE To explore the influence of double-pump dual-channel and double-pump single-channel on blood pressure of patients who were pumped with vasoactive drug injection.METHODS A total of 112 patients with septic shock who were hospitalized from Jan 2015 to Dec 2016 were enrolled in the study and randomly divided into the dual-channel group and the single-channel group, with 56 cases in each group.Both groups of patients were given the routine symptomatic therapy and liquid resuscitation, the dual-channel group was treated with double-pump dual-channel pump change mode, and the single-channel group was treated with double-pump single-channel pump change mode.The specimens were collected from the patients, the isolated pathogens were identified, the systolic pressure, maximum fluctuations of blood pressure and time of blood pressure fluctuations were recorded when the haemodynamics were basically stable, and the incidence of adverse reactions of the two groups of patients was recorded during the treatment.RESULTS Totally 62 strains of pathogens were isolated from the 56 patients in the dual-channel group, of which 69.35% （43 strains） were gram-negative bacteria,