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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

23卷

期数:

2017年04期

页码:

324-326

栏目:

临床医学

出版日期:

2017-07-02

文章信息/Info

Title:

Clinical study on limited fluid resuscitation in septic shock

文章编号:

1006-8147(2017)04-0324-03

作者:

齐 颖; 陈 兵

（天津医科大学第二医院ICU，天津 300211）

Author(s):

QI Ying; CHEN Bing

(Department of Critical Care Medicine, The Second Hospital, Tianjin Medical University, Tianjin 300211, China)

关键词:

脓毒症; 限制性液体复苏; 脓毒性休克 ; 脉波指示剂连续心排量检测

Keywords:

sepsis; limited fluid resuscitation; septic shock; PICCO

分类号:

R631

DOI:

-

文献标志码:

A

摘要:

目的：探讨限制性液体复苏容量对脓毒性休克的治疗意义。方法：将65例脓毒性休克患者随机分为2组：治疗组35例，其入院后24 h及72 h为显性液体平衡；对照组30例，其入院后24 h及72 h显性液体正平衡 。所有入选患者均于入院后行脉波指示剂连续心排量（PICCO）监测。比较两组患者病死率的差异及治疗组中存活组及死亡组胸内血容量指数(ITBI)、血管外肺水指数(ELWI)。结果：治疗组患者死亡率显著低于对照组，差异有统计学意义（P＜0.01）。治疗组患者液体显性平衡量显著低于对照组，差异有统计学意义（P＜0.01）。治疗组中存活组和死亡组比较ITBI无差异，ELWI在16 h后死亡组显著高于存活组（P＜0.05）。结论：脓毒性休克患者限制性液体复苏可以降低病死率。

Abstract:

Objective: To determine whether limited fluid resuscitation for septic shock is associated with mortality. Methods: Sixty-five septic shock patients were randomly divided into two groups: treatment group (n = 35), after visiting the hospital, patients in this group were in the dominant fluid balance during the first 24 h and 72 h, while the control group (n = 30), after visiting the hospital, had a positive dominant fluid balance during the first 24h and 72h. All selected patients should be examined with PICCO. The mortalities of the control group and the treatment group were analyzed. Meanwhile, the differences in ITBI, ELWI between the survival group and the death group in treatment group also were analyzed. Results: The mortality of the treatment group was lower than the control group. There were significant statistical differences between the two groups (P＜0.01). The fluid balance volume in treatment groups was lower than control groups. There were significant statistical differences between the two groups (P＜0.01).There were no differences in ITBI between the survival groups and the death groups in treatment group. But ELWI in death groups was higher than survival groups after 16 h (P ＜0.05). Conclusion: The limited fluid resuscitation in septic shock patients can decrease mortality.

参考文献/References:

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备注/Memo

备注/Memo:

基金项目 天津市卫生和计划生育委员会科技基金资助项目（2014KZ103）

作者简介 齐颖（1985-），女，住院医师，硕士在读，研究方向：脓毒症液体复苏；通信作者：陈兵，E-mail：tisheng2008@163.com。

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更新日期/Last Update: 2017-07-01