论文部分内容阅读
目的探讨早期目标导向治疗(EGDT)联用益气复脉冻干粉对脓毒性休克患者静-动脉血二氧化碳分压差[P(cv-a)CO2]及中心静脉血氧饱和度(ScvO2)的影响。方法 50例脓毒性休克患者按随机数字表法分为治疗组和对照组,各25例。对照组根据EGDT原则给予治疗,治疗组在EGDT的基础上加用注射用益气复脉冻干粉5.2 g加入生理盐水500 m L静脉滴注。观察两组患者治疗前后P(cv-a)CO2、ScvO2、乳酸、中心静脉压(CVP)、平均动脉压(MAP)及急性生理和慢性健康评分Ⅱ(APACHEⅡ)评分,观察两组患者6 h达标率及28天病死率情况。结果与本组治疗前比较,两组治疗后患者乳酸及APACHE II评分降低,ScvO2、MAP、CVP水平升高(P<0.01)。治疗组治疗后P(cv-a)CO2较本组治疗前明显降低,且低于对照组治疗后(P<0.05,P<0.01)。对照组6 h达标率为48%(12/25),治疗组为76%(19/25),对照组28天病死率为36%(9/25),治疗组为12%(3/25),两组比较差异均有统计学意义(P<0.05)。结论 EGDT联用益气复脉冻干粉可以显著升高ScvO2,降低脓毒性休克患者的P(cv-a)CO2及病死率,明显提高临床疗效。
Objective To investigate the effects of early target-directed therapy (EGDT) combined with gas-enriched rehydrated lyophilized powder on the partial pressure of arterial-arterial carbon dioxide (P cv-a CO2) and central venous oxygen saturation (ScvO2) in patients with septic shock Impact. Methods Fifty patients with septic shock were divided into treatment group and control group according to random number table method, each with 25 cases. The control group was treated according to the principle of EGDT. The treatment group was treated with EGDT plus intravenous injection of Qiqi Fumai lyophilized powder (5.2 g) and saline (500 m L). The levels of C (subscript cv-a) CO2, ScvO2, lactate, CVP, MAP and acute physiology and chronic health score Ⅱ (APACHEⅡ) were observed before and after treatment in both groups. Compliance rate and 28-day mortality rate. Results Compared with those before treatment, the levels of lactic acid and APACHE II in both groups decreased and the levels of ScvO2, MAP and CVP increased (P <0.01). After treatment, P (cv-a) CO2 in the treatment group was significantly lower than that in the control group before treatment (P <0.05, P <0.01). In the control group, the compliance rate was 48% (12/25) at 6 hours, 76% (19/25) in the treatment group, and 36% (9/25) at the 28th day in the control group, with 12% in the treatment group ), The differences between the two groups were statistically significant (P <0.05). Conclusion EGDT combined with Yiqi Fumai freeze-dried powder can significantly increase ScvO2, reduce P (cv-a) CO2 and mortality in patients with septic shock, and significantly improve clinical efficacy.