临床合理用药杂志
臨床閤理用藥雜誌
림상합리용약잡지
CHINESE JOURNAL OF CLINICAL RATIONAL DRUG USE
2014年
23期
10-11
,共2页
感染性休克%NE%血管外肺水肿
感染性休剋%NE%血管外肺水腫
감염성휴극%NE%혈관외폐수종
Septic shock%NE%Extravascular lung water
目的：探讨感染性休克液体复苏同时加用去甲肾上腺素（NE）对达到复苏目标的影响。方法选择2012年4月-2014年2月收治的感染性休克38例，随机分为对照组（充分积极液体复苏）和治疗组（充分积极液体复苏同时加用 NE）各19例，比较2组在入 ICU 0h、3h、6h 时的平均动脉压（MAP）、中心静脉压（CVP）、血管外肺水（EV-LW）、中心静脉血氧饱和度（ScvO2）、乳酸清除率及补充液体量。结果治疗组在0h、3h、6h 时的 MAP、CVP、ScvO2均高于对照组，于6h 时更明显，差异有统计学意义（P ﹤0.05）；而 EVLW 及补充液体量在0h、3h、6h 时低于对照组，但差异无统计学差异；治疗组6h 时乳酸清除率明显高于对照组，差异有统计学意义（P ﹤0.05），且治疗组高的乳酸清除率比例也明显高于对照组，差异有统计学意义（P ﹤0.05）。结论感染性休克早期应用 NE 可加快复苏，减少 EVLW 及液体补充量。
目的：探討感染性休剋液體複囌同時加用去甲腎上腺素（NE）對達到複囌目標的影響。方法選擇2012年4月-2014年2月收治的感染性休剋38例，隨機分為對照組（充分積極液體複囌）和治療組（充分積極液體複囌同時加用 NE）各19例，比較2組在入 ICU 0h、3h、6h 時的平均動脈壓（MAP）、中心靜脈壓（CVP）、血管外肺水（EV-LW）、中心靜脈血氧飽和度（ScvO2）、乳痠清除率及補充液體量。結果治療組在0h、3h、6h 時的 MAP、CVP、ScvO2均高于對照組，于6h 時更明顯，差異有統計學意義（P ﹤0.05）；而 EVLW 及補充液體量在0h、3h、6h 時低于對照組，但差異無統計學差異；治療組6h 時乳痠清除率明顯高于對照組，差異有統計學意義（P ﹤0.05），且治療組高的乳痠清除率比例也明顯高于對照組，差異有統計學意義（P ﹤0.05）。結論感染性休剋早期應用 NE 可加快複囌，減少 EVLW 及液體補充量。
목적：탐토감염성휴극액체복소동시가용거갑신상선소（NE）대체도복소목표적영향。방법선택2012년4월-2014년2월수치적감염성휴극38례，수궤분위대조조（충분적겁액체복소）화치료조（충분적겁액체복소동시가용 NE）각19례，비교2조재입 ICU 0h、3h、6h 시적평균동맥압（MAP）、중심정맥압（CVP）、혈관외폐수（EV-LW）、중심정맥혈양포화도（ScvO2）、유산청제솔급보충액체량。결과치료조재0h、3h、6h 시적 MAP、CVP、ScvO2균고우대조조，우6h 시경명현，차이유통계학의의（P ﹤0.05）；이 EVLW 급보충액체량재0h、3h、6h 시저우대조조，단차이무통계학차이；치료조6h 시유산청제솔명현고우대조조，차이유통계학의의（P ﹤0.05），차치료조고적유산청제솔비례야명현고우대조조，차이유통계학의의（P ﹤0.05）。결론감염성휴극조기응용 NE 가가쾌복소，감소 EVLW 급액체보충량。
Objective To explore the effects of fluid resuscitation combined with norepinephrine(NE)on early ther-apy in patients with septic shock. Methods 38 cases of patients with septic shock were assigned to control group(full aggres-sive fluid resuscitation)and treatment group(full aggressive fluid resuscitation combined with NE)randomly,each of 19 ca-ses. Mean artery pressure(MAP),central venous pressure(CVP),extravascular lung water(EVLW),mixed venous oxygen saturation(ScvO2 ),early lactate clearance rate and fluid infusions were measured and compared at begin,the three hour and the six hour after cure. Results The MAP,CVP and ScvO2 were higher in treatment group than that in control group,especial-ly in the six hour after treatment,the differences were statistically significant(P ﹤ 0. 05). EVLW and fluid infusions of each time in treatment group were lower than that in control group,the differences were statistically significant(P ﹤ 0. 05). Early lactate clearance in the treatment group were significantly higher than that in the control group,the differences were statistically significant(P ﹤ 0. 05). The proportion of high early lactate clearance in the treatment group were significantly higher than that in the control group,the differences were statistically significant(P ﹤ 0. 05). Conclusions Early application of NE in patients with septic shock can accelerate the recovery and reduce EVLW and fluid infusions.
