早期目标导向复苏治疗达标对感染性休克患者血流动力学及脑损伤的影响

Effect of early goal-directed resuscitation therapy meeting the standard on hemodynamics and brain injury in patients with septic shock

目的探讨早期目标导向复苏治疗(EGDT)达标对感染性休克患者血流动力学及脑损伤的影响。方法以2020年1月~2021年6月收治的74例早期感染性休克患者为研究对象,全部患者均接受EGDT,床旁血流动力学监测,依据治疗6 h时有无达到液体复苏目标,将患者分为A组(EGDT复苏目标达标,55例)和B组(EGDT复苏目标未达标,19例)。比较观察治疗前及EGDT复苏6 h时,两组患者血流动力学指标HR、MAP、CVP、CO、CI、SVI,另采集两组静脉血样,测定患者血清NSE与S100-β蛋白浓度,评价两组脑损伤情况。结果A组EGDT复苏6 h时HR低于B组,MAP、CI、SVI高于B组,差异有统计学意义(P<0.05)。A组EGDT复苏6 h时NSE、S100-β均低于B组,差异有统计学意义(P<0.05)。结论EGDT达标可以有效改善感染性休克患者血流动力学,对减轻脑损伤、促进脑功能恢复具有积极作用。

Objective To explore the effect of early goal-directed resuscitation therapy(EGDT)meeting the standard on hemodynamics and brain damage in patients with septic shock.Methods Taking 74 patients with early septic shock admitted to our hospital from January 2020 to June 2021 as the research object,all patients received EGDT and bedside hemodynamic monitoring.According to whether the fluid resuscitation goal was achieved at 6 hours of treatment,the patients were divided into group A(resuscitation goals was achieved,55 cases)and group B(resuscitation goals was not achieved,19 cases).Before treatment and 6 hours after EGDT resuscitation,to compared HR,MAP,CVP,CO,CI,SVI of the two groups of patients.The other two groups of venous blood samples were collected to determine the serum NSE and S100-βprotein concentrations of the patients to evaluate the brain damage situation of the two groups.Results HR in group A was lower than that of group B at 6 h after EGDT resuscitation,MAP,CI,SVI was higher in group B,the difference was statistically significant(P<0.05).NSE and S100-βin group A were lower than those of group B at 6 hours after EGDT resuscitation,and the difference was statistically significant(P<0.05).Conclusion EGDT meeting the standard can effectively improve the hemodynamics of patients with septic shock,and also has a positive effect on reducing brain damage and promoting the recovery of brain function.