不同液体早期复苏对感染性休克患者APACHEⅡ评分及脑钠肽水平的影响

Effect of Early Resuscitation of Different Fluids on APACHE Ⅱ Score and Brain Natriuretic Peptide in Patients with Septic Dhock

目的探索不同液体早期复苏对感染性休克患者APACHEⅡ评分及脑钠肽水平的影响。方法选取2016年1月至2017年6月于我院接受治疗的感染性休克患者60例为研究对象,将所有患者随机分入4个治疗组,每组患者给予不同种类复苏液体,其中A组予生理盐水复苏;B组予羟乙基淀粉溶液复苏;C组予乳酸林格液;D组予醋酸钠钾镁钙葡萄糖注射液(ASPMCG液)复苏;按照早期目标导向治疗进行血流动力学干预,观察并比较4组患者复苏6h后达标率、复苏前与复苏后72h APACHEⅡ评分及血浆脑钠肽水平。结果四组患者复苏6h后达标率无统计学差异;C、D两组复苏后72h APACHEⅡ评分及血浆脑钠肽水平显著低于A、B两组,其中D组效果略优于C组。结论乳酸林格液及ASPMCG液均可有效降低感染性休克患者复苏后72h APACHEⅡ评分及血浆脑钠肽水平,改善患者预后,其中ASPMCG液效果略优于乳酸林格液。

Objective To explore the effects of early resuscitation of different fluids on APACHE Ⅱ scores and brain natriuretic peptide levels in patients with septic shock;Methods 60 patients with septic shock who were treated in our hospital from January 2016 to June 2017 were enrolled.All patients were randomly assigned to four treatment groups.Each group received different types of resuscitation fluid,of which A The group was resuscitated with saline;group B was resuscitated with hydroxyethyl starch solution;group C was given lactated Ringer's solution;group D was treated with sodium acetate potassium magnesium calcium glucose injection(ASPMCG solution);blood flow was performed according to early target-directed therapy.The intervention was performed to observe and compare the compliance rate of the four groups of patients after 6 hours of resuscitation,the APACHE Ⅱ score before resuscitation and 72 hours after resuscitation,and the plasma brain natriuretic peptide level.Results There was no significant difference in the compliance rate between the four groups after 6 hours of resuscitation.The APACHE Ⅱ score and plasma brain natriuretic peptide level in the C and D groups were significantly lower than those in the A and B groups;Group D was slightly better than Group C.Conclusion Lactate Ringer's solution and ASPMCG injection can effectively reduce the APACHE Ⅱ score and plasma brain natriuretic peptide level after 72 hours of resuscitation in patients with septic shock,and improve the prognosis of patients with ASPMCG injection.The effect is slightly better than lactated Ringer's solution.