间歇气压疗法减轻脓毒症患者水肿的效果观察

目的探讨间歇气压疗法(IPC)减轻脓毒症患者组织水肿的疗效。方法选择我院2007年10月—2011年3月ICU和CCU收治的脓毒症伴组织水肿的患者120例,尿量<0.5 ml.kg-1.h-1,随机分为两组,对照组给予呋塞米20 mg静脉注射,IPC组给予呋塞米20 mg静脉注射后立即进行IPC,分别记录两组应用呋塞米前和后0.5 h、1 h和2 h的尿量和髌骨上缘15 cm和髌骨下缘10 cm大腿周径的值。结果应用呋塞米前两组尿量、髌骨上缘15 cm大腿周径、髌骨下缘10 cm大腿周径比较,差异均无统计学意义(P>0.05)。应用呋塞米后0.5 h、1 h和2 h,两组尿量比较差异均无统计学意义(P>0.05);IPC组髌骨上缘15 cm大腿周径和髌骨下缘10 cm大腿周径较对照组均明显降低,差异有统计学意义(P<0.05)。结论 IPC不能使尿量增加,但可短期减轻脓毒症患者的下肢水肿,增加IPC治疗频次,水肿减轻的效果可能会更好。

Effect of Intermittent Pneumatic Compression on Relieving Edema in Patients with Sepsis

Objective To investigate the therapeutic effect of intermittent pneumatic compression(IPC) on relieving tissue edema in patients with sepsis.Methods 120 sepsis patients accompanied with tissue edema admitted to ICU and CCU of our hospital from October 2007 to March 2011 were involved into the study.The patients′ urine volume was<0.5 ml·kg-1·h-1 and they were divided into two groups.The control group was given intravenous injection of 20 mg frusemide and the IPC group was firstly given intravenous injection of 20 mg frusemide and was then given IPC immediately.Urine volume and circumference diameter of the legs 15 cm superior border to whirbone and 10 cm inferior border to whirbone were recorded 0.5 h,1 h and 2 h before and after the injection of frusemide.Results The urine volume and circumference diameter of legs 15 cm superior border to whirbone and 10 cm inferior border to whirbone of the two groups before the injection of frusemide showed no statistically significant differences(P>0.05).0.5 h,1 h and 2 h after the injection of frusemide,the urine volume of the two groups showed no statistically significant difference(P>0.05).The circumference diameter of legs 15 cm superior border to whirbone and 10 cm inferior border to whirbone of the IPC group was significantly decreased compared with that of the control group(P<0.05).Conclusion IPC cannot increase the urine volume,but it can relieve edema of lower extremity in sepsis in short term.The therapeutic effect on relieving edema in sepsis will be better if the frequency of IPC is increased.