摘要
目的:探讨基于中心静脉-动脉二氧化碳分压差(Pcv-aCO_(2))、乳酸、容量反应性指标的早期目标导向液体复苏治疗(EGDT)优化方案在脓毒性休克液体复苏中的价值,指导更加精准的液体复苏治疗。方法:选取2020年1月-2021年8月就诊于阿克苏地区第一人民医院CCU需要复苏治疗的脓毒性休克患者80例,按照随机数字表法分为治疗组和对照组,各40例。对照组采用传统EGDT方案进行复苏,治疗组采用EGDT优化方案进行液体复苏,评估两组28 d死亡率、机械通气时间、ICU住院时间、多器官功能障碍综合征(MODS)发生率等预后指标。结果:治疗组28 d死亡率虽低于对照组,但差异无统计学意义(P>0.05);治疗组MODS发生率低于对照组,差异有统计学意义(P<0.05);治疗组机械通气时间、ICU住院时间均短于对照组,差异均有统计学意义(P<0.05)。结论:基于Pcv-aCO_(2)、乳酸、容量反应性指标的EGDT优化方案可指导脓毒性休克更加精准的液体复苏治疗。
Objective:To explore the value of optimized early goal-directed fluid resuscitation(EGDT)optimization scheme based on central venous-to-arterial carbon dioxide difference(Pcv-aCO_(2)),lactic acid and volume reactivity indexes in fluid resuscitation of septic shock,and to guide more accurate fluid resuscitation therapy.Method:Eighty patients with septic shock who needed resuscitation treatment admitted to CCU of the First People’s Hospital of Aksu Prefecture from January 2020 to August 2021 were selected,and they were randomly divided into the treatment group(n=40)and the control group(n=40)according to random number table method.The control group was given traditional EGDT resuscitation,and the treatment group was given EGDT optimization scheme fluid resuscitation.The 28-day mortality,duration of mechanical ventilation,length of ICU stay,incidence of MODS and other prognostic indicators between two groups were evaluated.Result:Although the 28-day mortality of the treatment group was lower than that of the control group,but the difference was not statistically significant(P>0.05).The incidence of MODS in the treatment group was lower than that in the control group,the difference was statistically significant(P<0.05).The mechanical ventilation time and ICU stay time of the treatment group were shorter than those of the control group, and the differences were statistically significant (P<0.05). Conclusion: EGDT optimization scheme based on Pcv-aCO_(2), lactic acid and volume reactivity indexes can guide more accurate fluid resuscitation treatment of septic shock.
作者
魏丽丽
刘秉宇
王雪莉
吴兆龙
WEI Lili;LIU Bingyu;WANG Xueli;WU Zhaolong(The First People’s Hospital of Aksu Prefecture,Aksu 843000,China;不详)
出处
《中外医学研究》
2022年第32期134-137,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
阿克苏地区第一人民医院院级科研项目(YJKT2020-10)。
关键词
中心静脉-动脉二氧化碳分压差
脓毒性休克
液体复苏
Central venous-to-arterial carbon dioxide difference
Septic shock
Fluid resuscitation
