目标导向液体治疗对异位妊娠失血性休克患者组织灌注的影响

Effect of goal directed fluid therapy on tissue perfusion in patients with ectopic pregnancy hemorrhagic shock

目的观察目标导向液体治疗对异位妊娠失血性休克患者组织灌注的影响。方法选取2017年1月—2019年12月广东省东莞市厚街医院收治的异位妊娠失血性休克患者60例,采用随机数字表法分为观察组和对照组,每组30例。观察组采用目标导向液体治疗,对照组采用常规输液治疗。比较2组治疗前后尿量、中心静脉压、平均动脉压及血管活性药物使用率。结果手术开始1 h,2组患者尿量均大于术前,中心静脉压及平均动脉压均高于术前,且观察组变化幅度大于对照组(P<0.01)。观察组血管活性药物使用率为6.67%(2/30),低于对照组的26.67%(8/30)(χ^(2)=4.320,P=0.038)。结论对异位妊娠失血性休克患者实施目标导向液体治疗对其组织灌注产生的影响十分显著,能使液体复苏更加有效,减少血管活性药物的使用,值得在临床中积极推广应用。

Objective To explore the effect of goal directed fluid therapy on tissue perfusion in patients with ectopic pregnancy hemorrhagic shock.Methods A total of 60 patients with hemorrhagic shock of ectopic pregnancy who were admitted to Houjie Hospital of Dongguan,Guangdong Province from January 2017 to December 2019 were selected,and they were divided into observation group and control group by random number table method,with 30 cases in each group.The observation group was treated with goal oriented fluid therapy,and the control group was treated with conventional fluid infusion.The urine output,central venous pressure,average artery pressure and the use rate of vasoactive drugs were compared between the two groups before and after treatment.Results One hour after the operation,the urine output of the patients in the two groups were greater than that before the operation,the central venous pressure and the average artery pressure were higher than those before the operation,and the variation range of the observation group was greater than that of the control group(P<0.01).The use rate of vasoactive drugs in the observation group was 6.67%(2/30),which was lower than 26.67%(8/30)in the control group(χ^(2)=4.320,P=0.038).Conclusion Goal directed fluid fluid therapy for patients with hemorrhagic shock of ectopic pregnancy has a significant impact on their tissue perfusion,which can make fluid resuscitation more effective and reduce the use of vasoactive drugs,it is worthy of active promotion and application in clinical practice.