摘要
目的:比较碳酸氢钠林格液、复方氯化钠注射液用于脓毒性休克的治疗效果.方法:选取2019 年4 月至2022 年4 月新乡市中心医院收治的脓毒性休克患者80 例,分为A、B组,每组40 例.A组接受碳酸氢钠林格液注射液限制性液体复苏,B组接受复方氯化钠注射液限制性液体复苏.比较两组患者复苏处理后0、1、3、6、12、24、48 h乳酸清除率,复苏第0、6、12、24、48 h电解质指标(K+、Na+、Cl-),血流动力学恢复稳定时间(中心静脉压恢复时间、平均动脉压恢复时间),ICU住院时间,死亡率以及0、6、12、24、48 h快速序贯器官衰竭评分(qSoFA评分),48 h内所用液体总量,不良事件发生率.结果:0～48 h,两组乳酸清除率均呈升高趋势,A组高于B组(P<0.05).两组不同时间点K+、Na+水平差异无统计学意义(P>0.05),Cl-水平有随时间升高的趋势,且A组12、24、48 h Cl-水平低于B组(P<0.05).与B组相比,A组中心静脉压恢复时间、平均动脉压恢复时间、ICU住院时间更短,死亡率更低(P<0.05).qSoFA评分有随时间降低的趋势,且A组 12、24、48 h qSoFA评分低于B组(P<0.05).A组48h内所用液体总量少于B组(P<0.05).两组不良事件发生率差异无统计学意义(P =0.644).结论:碳酸氢钠林格液限制性液体复苏治疗脓毒性休克效果更好.
Abstract
Aim:To explore the application value of sodium bicarbonate Ringer's solution and compound sodium chlo-ride injection in treatment of septic shock.Methods:A total of 80 patients with septic shock admitted to Xinxiang Central Hospital from April 2019 to April 2022 were allocated into group A and group B,with 40 in each group.Group A received sodium bicarbonate Ringer's solution restricted liquid resuscitation,and group B received compound sodium chloride injec-tion restricted liquid resuscitation.The lactate clearance rate at 0,1,3,6,12,24,48 hour,electrolyte indexes(K+,Na+,Cl-)at 0,6,12,24,48 hour after resuscitation,hemodynamic stabilization time[central venous pressure(CVP)recovery time,mean arterial pressure(MAP)recovery time],ICU stay and mortality were compared between the 2 groups.Rapid se-quential organ failure score(qSoFA)at 0,6,12,24,48 hour,total fluid volume used within 48 hours,and adverse event rate were also compared.Results:The lactic acid clearance rate within 48 hours in both groups increased,which was higher in group A compared with group B(P<0.05).There was no significant difference in K+ or Na+ between the2 groups at dif-ferent time points(P>0.05);at 12,24,and 48 hour,Cl-in group A was lower than that in group B(P<0.05).Compared with group B,group A had shorter CVP recovery time,MAP recovery time,ICU stay,and lower mortality(P<0.05).qSoFa in both groups decreased with time;compared with group B,patients in group A had lower qSoFA scores at 12,24,and 48 hour(P<0.05).There was no significant difference in the incidence of adverse events between group A and group B(P>0.05).Compared with group B,the total liquid volume used within 48 hours in group A was significantly less(P<0.05).Conclusion:Compared with compound sodium chloride injection,patients with septic shock who receive sodium bicarbonate Ringer's solution restricted liquid resuscitation have better outcome.
基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20191327)
维普
万方数据