艾司洛尔联合早期目标导向液体复苏治疗脓毒症休克的临床观察

Clinical Observation of Esmolol Combined with Early Target-directed Fluid Resuscitation for Septic Shock

目的观察艾司洛尔联合早期目标导向液体复苏治疗脓毒症休克患者的临床效果。方法选择2021年1月至2023年1月在萍乡市人民医院接受治疗的80例脓毒症休克患者,按随机数字表法将其分为两组,各40例。对照组采用早期目标导向液体复苏治疗,在此基础上,观察组联合艾司洛尔治疗。比较两组临床疗效、心肌功能指标、乳酸水平、炎症因子指标、病情严重程度以及不良事件发生情况。结果治疗后,观察组总有效率较对照组高(P<0.05);观察组B型尿钠肽(BNP)、肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)水平较对照组低(P<0.05);观察组乳酸、C反应蛋白(CRP)、白细胞计数(WBC)、降钙素原(PCT)水平均较对照组低(P<0.05);观察组急性生理学及慢性健康状况评分(APACHEⅡ)、序贯器官衰竭评分(SOFA)评分均较对照组低(P<0.05)。两组不良事件总发生率比较差异无统计学意义(P>0.05)。结论脓毒症休克患者实施艾司洛尔联合早期目标导向液体复苏治疗效果确切,能够有效改善患者心肌功能指标,调节患者乳酸水平,并降低炎症因子指标,改善预后。

Objective To observe the clinical effect of esmolol combined with early target-directed liquid resuscitation in the treatment of septic shock patients.Methods 80 patients with septic shock treated in Pingxiang People's Hospital from January 2021 to January 2023 were selected and divided into two groups with 40 cases each according to random number table method.The control group was treated with early target-directed liquid resuscitation,and the observation group was treated with esmolol on the basis of the control group.The clinical efficacy,myocardial function index,lactate level,inflammatory factor index,severity of disease and adverse events were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the levels of B-type natriuretic peptide(BNP),troponin I(cTnI)and creatine kinase isoenzyme(CK-MB)in observation group were lower than those in control group(P<0.05);lactate,C-reactive protein(CRP),white blood cell count(WBC)and procalcitonin(PCT)levels in observation group were lower than those in control group(P<0.05);acute physiology and chronic health status score(APACHEⅡ)and sequential organ failure score(SOFA)in observation group were lower than those in control group(P<0.05).There was no statistically significant difference in the total incidence of adverse events between the two groups(P>0.05).Conclusion Esmolol combined with early target-directed liquid resuscitation therapy is effective in septic shock patients,which can effectively improve myocardial function indexes,regulate lactate level,reduce inflammatory factor indexes and improve prognosis.