摘要
目的探讨3%高渗生理盐水对儿童脓毒性休克的早期复苏的疗效。方法选取在本院PICU治疗的脓毒性休克患儿160例,随机分为治疗组与对照组,每组80例。对照组患儿规范输注0.9%生理盐水。治疗组患儿于10~15 min内输注6 m L/kg的3%高渗盐水。检验平均动脉压(MAP)、氧合指数(OI)、心率、血钠、输液量、动脉血乳酸(24h-Lac)等指标,。结果治疗组与对照组在本组内多时间点比较,OI[治疗组,基线(296.6±58.3)mm Hg,24 h(336.2±55.3)mm Hg;对照组,基线(304.3±70.5)mm Hg,24 h(325.8±62.7)mm Hg]、MAP[治疗组,基线(47.3±9.7)mm Hg,24 h(59.4±7.1)mm Hg;对照组,基线(48.4±11.1),24 h(59.5±8.1)mm Hg]与心率值[治疗组,基线(165.5±28.3)次/min,24 h(130.9±22.0)次/min;对照组,基线(172.3±22.5)次/min,24 h(134.6±23.5)次/min]比较,差异有统计学意义(P<0.05);两组患者各治疗时间点的MAP与心率比较差异有统计学意义(P<0.05);治疗组的OI值在第3小时显著改善(P<0.05),而对照组在第24小时显著改善(P<0.05);治疗组血钠指标在第1小时显著高于对照组(P<0.05)。与对照组比较,治疗组患儿6 h与24 h输液量显著减少,差异有统计学意义(P<0.05)。治疗组与对照组患儿MODS发生率(77.5%vs 71.3%)与死亡率(3.8%vs 6.3%)比较差异无统计学意义。结论 3%高渗盐水对儿童脓毒症患者进行液体复苏疗效好,不良反应少、安全性高,值得临床推广。
Objective To investigate the effect of3%hypertonic saline on the early recovery of septic shock in children.Methods160patientswith septic shock treated with PICU in our hospital were randomly divided into treatment group and control group(n=80).In the control group,0.9%normal saline was infused.The patients in the treatment group were infused with6ml/kg3%hypertonic saline in10~15min.The mean arterialpressure(MAP),oxygenation index(OI),heart rate,serum sodium,infusion volume and arterial lactic acid(24h-Lac)were compared by t test.ResultsTreatment group compared with control group in this time more,OI[treatment group,the baseline(296.6±58.3)mmHg,24h(336.2±55.3)mmHg;the control group,the baseline(304.3±70.5)mmHg,24h(325.8±62.7)mmHg],the MAP[the treatment group,the baseline(47.3±9.7)mmHg,24h(59.4±7.1)mmHg;the control group,the baseline(48.4±11.1),24h(59.5±8.1)mmHg)and heart rate value[treatment group,the baseline(165.5±28.3)times/min,24h(130.9±22.0)times/min,the control group,the baseline(172.3±22.5)times/min,24h(134.6±23.5)times/min),thedifference was statistically significant(P<0.05);Two groups of patients with the treatment time point of the MAP and the heartbeat is difference wasstatistically significant(P<0.05);OI value of the treatment group improved significantly in3hours(P<0.05),while the control group in the24hoursimproved significantly(P<0.05);Treatment group serum sodium indicators in the first hour is significantly higher than control group(P<0.05).Comparedwith control group,treatment group with6h and24h infusion quantity is significantly reduced,the difference was statistically significant(P<0.05).Treatment group and control group with MODS incidence(77.5%vs71.3%)and mortality(3.8%vs6.3%),there was no statistically significantdifference comparison.Conclusion3%hypertonic saline on children sepsis patients with liquid recovery good curative effect,less adverse reaction,high safety,worth clinical promotion..
作者
郑烜
赵娟娟
焦慧超
赵杨
Zheng Xuan;Zhao Juan-juan;Jiao Hui-chao;Zhao Yang(Department of Equipment, Children's Hospital of Kaifeng, Kaifeng, Henan,475000, China;Department of Pharmacy,Children's Hospital of Kaifeng, Kaifeng, Henan,475000, China;Department of Nursing, Huaihe Hospital of Henan University Kaifeng, Henan,475000, China)
出处
《当代医学》
2017年第9期27-30,共4页
Contemporary Medicine
关键词
高渗盐水
液体复苏
脓毒性休克
Hypertonic saline
Fluid resuscitation
Septic shock
