Effect of prostaglandin E1 combined with target-oriented fluid resuscitation on septic shock,vascular endothelial function and tissue perfusion
Objective To explore the clinical effect of prostaglandin E1 combined with target-oriented fluid resuscitation on septic shock,vascular endothelial function,and tissue perfusion level.Methods One hundred and fifty patients with septic shock treated in our hospital from January 2019 to December 2021 were collected and divided into two groups by random number report method.The control group was given early goal-directed fluid resuscitation,while the observation group was given prostaglandin E1 combined with early goal-directed fluid resuscitation.The clinical therapeutic effect,vascular endothelial function,and tissue perfusion level were compared between the two groups.Results Compared with the control group,the dosage of resuscitation fluid[(3 173±632)ml vs(3 613±562)ml]and dobutamine[(53±10)mg vs(64±7)mg]in the observation group were significantly reduced.The successful resuscitation time[(4.4±1.0)h vs(4.7±1.1)h]and dobutamine time[(5.2±1.6)d vs(5.8±1.8)d]were shortened,and the rate of ARDS decreased significantly(1.3)％vs(10.7％),and the differences were statistically significant(P＜0.05).The APACHE Ⅱ score[(17±5)vs(19±3),(13±5)vs(16±3)],SOFA score[(8.7±2.5)vs(9.8±2.8),(6.1±2.0)vs(7.4±2.4)]in the observation group at 6h and 48 h after resuscitation were significantly lower than those of the control group,the levers of serum ET-1[(45±14)pg/ml vs(50±15)pg/ml],sTM[(3.1±0.9)ng/ml]vs(3.7±1.1)ng/ml],E-SLT[(26±6)ng/ml vs(28±6)ng/ml],blood lactate[(3.2±1.0)mmol/L vs(3.6±1.0)mmol/L],O2UR[(24±5)mmHg vs(26±5)mmHg]at 48 h after resuscita tion were significantly lower than those of the control group,the levels of SCVO2[(81±7)％vs(78±8)％],SVRI[(1 955±345)ds×m2/cm5 vs(1 826±413)ds×m2/cm5]were significantly higher than those of the control group,and the differences were statistically significant(P＜0.05).Conclusion Prostaglandin E1 combined with target-oriented fluid resuscitation can effectively reduce the total amount of resuscitation fluid in septic shock patients,shorten the time of fluid resuscitation and the use of vasoactive drugs,inhibit vascular endothelial injury,improve the tissue perfusion level and oxygen metabolism,and improve the prognosis of patients.
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维普
