液体负平衡应用于感染性休克患者对APACHEII评分的影响

摘要:目的 探讨液体负平衡对感染性休克患者急性生理学与慢性健康状态（APACHEII）评分的影响分析。方法 选取2018年1月～2020年1月本院收治的92例感染性休克患者，按不同液体管理模式分为常规组（采用液体平衡）和研究组（采用液体负平衡管理模式）各46例。对比分析2组患者心肺功能及APACHEII评分以及不良反应。结果 管理前2组患者全心舒张末期容量指数（GED-CVI）和血管外肺水指数（EVLWI）比较无统计学差异（P>0.05），管理后2组GED-CVI、EVLWI水平均增加（P＜0.05），研究组上述水平高于常规组（P＜0.05）；研究组和常规组均完成了管理计划，2组管理前APACHEII评分比较，差异均无统计学意义（P＞0.05），管理后均低于管理前（P＜0.05），管理后研究组低于常规组（P＜0.05）；2组患者均未见明显不良反应发生。结论 液体负平衡应用于感染性休克患者，可改善心肺功能指标，降低患者APACHEII评分，可作为临床管理及防控的参考指标。

Effect of fluid negative balance on APACHE II score in patients with septic shock

Abstract: Objective To investigate the effect of fluid negative balance on acute physiology and chronic health status (APACHE II) score in patients with septic shock. Methods ninety-two patients with septic shock treated in our hospital from January 2018 to January 2020 were divided into routine group (liquid balance was used) and study group (liquid negative balance management mode) according to different liquid management modes, with forty-six cases in each group. The cardiopulmonary function, APACHE II score and adverse reactions of the two groups were compared and analyzed. Results there was no significant difference in Whole-cardiac end-diastolic volume index (GED-CVI) and extrtravascular scula index (EVLWI) between the two groups before management (P > 0.05). After administration, GED-CVI and EVLWI increased significantly in the two groups (P < 0.05). the study group had higher above levels than the conventional group (P < 0.05). Both the study group and the routine group completed the management plan. There was no significant difference in APACHE II score between the two groups before management (P > 0.05). which was lower than that before management (P < 0.05). and that in the study group after management was lower than that in the routine group (P < 0.05). There were no significant adverse reactions in both groups. Conclusion the application of negative fluid balance in patients with septic shock can improve the indexes of cardiopulmonary function and reduce the APACHE II score. It can be used as a reference index for clinical management and prevention and control.