血必净注射液对脓毒性休克患者氧利用率、中心静脉血氧饱和度及乳酸影响的临床研究

目的:探讨血必净注射液(Xubijing injection)对脓毒性休克(Septic Shock)患者氧利用率(oxygen uti-lization coefficient,O2UC)、中心静脉血氧饱和度(Central venous oxygen saturation,ScvO2)和乳酸(Lactic acid,Lac)的影响,为血必净注射液在脓毒性休克的临床应用提供依据。方法:对符合纳入标准60例脓毒性休克患者随机分为治疗组(30例)和对照组(30例)。两组均给予西医常规治疗,治疗组同时给予血必净注射液静滴,对照组给予5%葡萄糖注射液静滴。分别在用药前,用药后2h、4h、6h、12h行动脉血及中心静脉血气分析,测定中心静脉血氧饱和度(ScvO2)和乳酸(Lac),计算氧利用率(O2UC),采用前瞻性自身前后及组间对照研究方法,收集数据进行统计分析。结果:①治疗前两组的Scv02、乳酸、氧利用率比较差异无统计学意义(P均)0.05);②治疗组用药后4h6、h、12h的ScvO2水平明显高于对照组,差异有统计学意义(P均0.05);③治疗组用药后6h、12h乳酸浓度均低于对照组同时点的乳酸浓度,差异有统计学意义(P0.05、P0.01);④治疗组用药后2h、6h、12h的氧摄取率高于对照组,两组比较差异均有统计学意义(P均0.05)。结论:在西医常规复苏治疗基础上加用血必净注射液治疗脓毒性休克患者,较单纯西医常规复苏治疗能更大程度地升高脓毒性休克患者的SCvO2,降低乳酸、增加氧利用率,从而改善感染性休克患者的全身氧代谢状况。

Clinical Observation on Effects of Xubijing Injection on Oxygen Utilization Coefficient,Central Venous Oxygen Saturation(ScvO2) and Lactic Acid in Patients with Septic Shock

Objective:To study the effect of Xubijing injection on O2UC、ScvO2 and Lactic acid in patients with septic shock.Methods:Sixty patients with septic shock were divided randomly into treatment group(n=30) and control group(n=30).Both of two groups were treated with conventional therapy.Patients in the treatment group were treated with Xubijing injection simultaneously.While patients in the control group were treated with 5% glucose injection.Artery blood and central vein blood were drawed for blood gas analysis before and at 2,4,6 and 12 hours after treatment in patients of both groups.Central venous oxygen extraction rate were tested.Results:There were no signification differences in ScvO2,lactic acid and O2UC between two groups before treatment(all P>0.05).The levels of Scv O2 at 4,6 and 12 hours after treatment in treatment group were obviously higher than those in control group(all P<0.05).And the concentration of lactic acid at 6 and 12 hours after treatment in treatment group were lower than those in treatment group(P<0.05、P<0.01).The O2UC at 2,6 and 12 hours after treatment in treatment group were higher than those in control group(all P<0.05).Conclusion:Contrast to conventional western resuscitation therapy,Xubijing injection combined with conventional western resuscitation therapy can more notably increase ScvO2,reduce blood lactic acid,increase oxygen utilization coefficient,and improve systemic oxygen metabolism in patients with septic shock.