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目的探讨Esmolol与Milinone联合用药治疗感染性休克的临床疗效。方法选择本院2010年2月至2015年10月收治的102例感染性休克患者,随机分为两组,其中治疗组63例,对照组39例;对两组患者的血乳酸清除率和碱剩余等血清学指标进行比较。结果两组患者平均动脉压、心指数、体循环阻力指数及中心静脉压在治疗期间差异均无统计学意义,治疗过程中治疗组和对照组患者血乳酸浓度均逐渐下降,但治疗组患者下降程度更为显著(t=2.41,P=0.02);治疗组患者治疗后每个时间段乳酸清除率均显著高于对照组(P均<0.05)。结论感染性休克患者往往出现明显的动脉血乳酸水平上升、碱剩余下降等代谢性酸中毒状态,Esmolol与Milinone联合用药能够在一定程度上缓解上述状态。动脉血乳酸清除率和碱剩作为血清学指标对该类患者的预后的判断有参考意义。
Objective To investigate the clinical efficacy of Esmolol combined with Milinone in the treatment of septic shock. Methods A total of 102 patients with septic shock admitted to our hospital from February 2010 to October 2015 were randomly divided into two groups: treatment group (63 cases) and control group (39 cases). Serum lactate clearance Remaining and other serological indicators were compared. Results There were no significant differences in mean arterial pressure, cardiac index, systemic resistance index and central venous pressure between the two groups during the treatment. Both the treatment group and the control group had a gradual decrease in blood lactate concentration during the treatment, but the degree of decline in the treatment group (T = 2.41, P = 0.02). The lactic acid clearance in each treatment group was significantly higher than that in the control group after treatment (all P <0.05). Conclusions In patients with septic shock, metabolic acidosis often occurs when arterial blood lactate level rises, and base surplus drops. Esmolol and Milinone can relieve the above state to a certain extent. Arterial lactate clearance and residual base as a serological indicator of the prognosis of such patients have a reference value.