血浆胶体渗透压指导下早期目标导向治疗感染性休克的临床效果

Clinical effect of early goal-directed therapy in the treatment of septic shock under guidance of plasma colloid osmotic pressure

目的观察血浆胶体渗透压(PCOP)指导下早期目标导向(EGDT)治疗感染性休克的临床效果。方法选取2017年3月~2018年3月在我院治疗的感染性休克患者70例,采用随机数字表法分为对照组和观察组,每组35例。对照组给予常规EGDT治疗;观察组在PCOP指导下进行EGDT治疗。比较两组治疗前及治疗24 h后急性生理与慢性健康(APACHEⅡ)评分;比较两组治疗后6、12、24 h乳酸清除率;比较两组患者ICU留置时间、14 d病死率及多器官功能障碍综合征(MODS)发生率。结果观察组治疗24 h后APACHEⅡ评分低于对照组,治疗后6、12、24 h乳酸清除率高于对照组(P<0.05);观察组ICU留置时间短于对照组,14 d病死率及MODS发生率低于对照组(P<0.05)。结论PCOP指导下EGDT感染性休克能缩短ICU留置时间,降低14 d病死率及MODS发生率。

Objective To observe the clinical effect of early goal-directed therapy(EGDT)in the treatment of septic shock under guidance of plasma colloid osmotic pressure(PCOP).Methods A total of 70 patients with septic shock who were treated in our hospital from March 2017 to March 2018 were enrolled.They were divided into control group and observation group by random number method,35 cases in each group.The control group was given routine EGDT,while observation group was given EGDT under guidance of PCOP.The acute physiology and chronic health evaluation(APACHE II)scores before treatment and after 24 hours treatment were compared between the two groups.The lactate clearance rates at 6,12 and 24 h after treatment were compared between the two groups.The ICU indwelling time,mortality and incidence of multiple organ dysfunction syndrome(MODS)were compared between the two groups.Results After 24 hours treatment,APACHE II score of observation group was lower than that of control group.At 6,12 and 24 h after treatment,clearance rate of lactate in observation group was higher than that in control group(P<0.05).ICU indwelling time in observation group was shorter than that in control group,14 d mortality rate and incidence of MODS were lower than those in control group(P<0.05).Conclusion EGDT in treatment of septic shock under PCOP guidance can shorten ICU indwelling time,reduce 14 d mortality rate and incidence of MODS.