3％氯化钠注射液在儿童脓毒性休克液体复苏中的作用

Effect of 3 % sodium chloride injection in the treatment of fluid resuscitation in children with sepsis shock

目的 探讨3%氯化钠注射液在儿童脓毒性休克液体复苏中的作用。方法 选择重症监护室收治的脓毒症患儿84例，采用随机数字表法分为两组各42例。对照组应用0.9%氯化钠注射液进行液体复苏，观察组则静脉缓慢给予3%氯化钠注射液进行液体复苏，观察两组容量复苏相关指标变化情况，比较两组容量复苏成功时间、住院时间及救治成功率。结果 治疗后，观察组收缩压、中心静脉压、24 h尿量分别为（85.6±4.3）mmHg、（7.1±0.5）cmH2O、（250.8±11.9）mL，对照组分别为（66.9±2.6）mmHg、（4.6±0.2）cmH2O、（50.1±5.0）mL，两组差异均有统计学意义（t＝23.536、29.361、98.339，均P〈0.05）；观察组容量复苏成功时间[（6.7±1.1）h]短于对照组[（18.5±2.3）h]（t＝29.272，P〈0.05），住院时间[（4.1±0.2）d]短于对照组[（6.3±0.5）d]（t＝25.838，P〈0.05），救治成功率（95.0%）高于对照组（65.0%）（χ2＝7.941，P〈0.05）。结论 针对儿童脓毒性休克，应用3%氯化钠注射液可有效地进行液体复苏，改善组织灌注，缩短住院时间，提高救治成功率。

Objective To investigate the effect of 3% sodium chloride injection on fluid resuscitation in children with septic shock.Methods Eighty-four children with sepsis in intensive care unit were selected and divided into two groups according to random number table method,42 cases in each group.The control group was treated with 0.9% sodium chloride injection for fluid resuscitation.The observation group was slowly given 3% sodium chloride injection for fluid resuscitation.The changes of the two groups Were observed.The success time of fluid resuscitation,hospitalization time and success rate of the two groups were compared.Results After intervention,the systolic blood pressure,central venous pressure and 24h urine output in the observation group were（85.6± 4.3）mmHg,（7.1 ± 0.5）cmH2O,（250.8 ± 11.9）mL,respectively,which in the control group were（66.9 ± 2.6）mmHg,（4.6 ± 0.2）cmH2O,（50.1 ±5.0）mL,respectively,the differences between the two groups were statistically significant（t = 23.536,29.361 and 98.339,all P 〈 0.05）.The success time of fluid resuscitation,hospitalization time of the observation group were（6.7 ± 1.1）h,（4.1 ± 0.2）d,respectively,which were significantly shorter than those of the control group [（18.5 ± 2.3）h,（6.3 ±0.5）d,t = 29.272,25.838,all P 〈 0.05）.The success rate of treatment of the observation group（95.0%）was higher than that of the control group（65.0%）（χ2 = 7.941,P 〈 0.05）.Conclusion 3% sodium chloride injection can effectively treat fluid resuscitation,improve tissue perfusion,shorten the hospitalization time and improve the success rate of treatment for children with septic shock.