个性化液体复苏联合去甲肾上腺素、血必净治疗早期感染性休克患者临床疗效

目的 探讨个性化液体复苏联合去甲肾上腺素、血必净治疗早期感染性休克患者临床疗效.方法 选取自2018年1月至2019年6月上海交通大学医学院附属新华医院崇明分院收治的90例感染性休克患者为研究对象.根据患者的治疗方法分为A组(n=42)与B组(n=48).A组患者给予去甲肾上腺素联合血必净治疗,B组患者给予个性化液体复...

Clinical effect of personalized fluid resuscitation combined with norepinephrine and Xuebijing in the treatment of patients with early septic shock

Objective To investigate the effects of personalized fluid resuscitation combined with norepinephrine and Xuebijing on acute renal injury in patients with early septic shock.Methods A retrospective study was performed on 90 cases of patients with septic shock who were admitted from January 2018 to June 2019.According to different treatment methods,patients were divided into the Group A(n=42)and Group B(n=48).Patients of Group A were given norepinephrine combined with Xuebijing,the ones of Group B were given personalized fluid resuscitation combined with norepinephrine and Xuebijing.The vital signs[heart rate,mean arterial pressure(MAP)],the biochemical indicators[lactic acid,hydrogen carbonate(HCO-3),blood urea nitrogen(BUN),serum creatinine(Scr)],the hemodynamics[central venous pressure(CVP),cardiac index(CI),blood oxygen saturation(SpO₂)and venous oxygen saturation(SvO₂)]and the acute physiology and chronic health evaluationⅡ(APACHEⅡ)were recorded and compared before,7 days and 14 days after treatment.Results The total effective rate in Group B was 83.3%(40/48),which was significantly higher than that in Group A(76.2%,32/42),and the difference was statistically significant(P<0.05).On day 7 and 14 of treatment,heart rate and MAP of both groups were significantly lower than those before treatment(P<0.05).After 7 and 14 days of treatment,heart rate in Group B was significantly lower than that in Group A(P<0.05).After 14 days of treatment,MAP in Group B was significantly higher than that in Group A(P<0.05).The expression levels of lactic acid,BUN and Scr in both groups were significantly lower than those before treatment,and the expression levels of HCO-3 in both groups were significantly higher than those before treatment(P<0.05).After 7 and 14 days of treatment,the expression levels of lactic acid,BUN and Scr in Group B were significantly lower than those in Group A,and the expression level of HCO-3 was significantly higher than that in Group A(P<0.05).The levels of CVP,CI,SvO₂ and SpO₂ in both groups at 7 and 14 days of treatment were significantly higher than before treatment(P<0.05).After 7 and 14 days of treatment,the levels of CVP,CI,SvO₂ and SpO₂ in Group B were significantly higher than those in Group A(P<0.05).After 7 and 14 days of treatment,APACHEⅡscores in both groups of patients were significantly lower than those before treatment,and APACHEⅡscores in Group B were significantly lower than those in Group A(P<0.05).Conclusion Personalized fluid resuscitation combined with norepinephrine and Xuebijing for early septic shock can effectively improve patient′s renal function and improve the curative effect.