早期目标导向治疗严重脓毒性休克40例临床观察

目的 观察早期目标导向治疗(EGDT)治疗脓毒性休克的临床疗效.方法 将符合病例入选标准的80例脓毒性休克患者随机分为观察组、对照组,每组40例.对照组在积极控制原发性感染的基础上,给予晶体液、胶体液或白蛋白等进行常规液体扩容循环与容量支持治疗,同时应用血管活性药物.观察组给予早期目标导向疗法治疗.结果 CVP、MAP、ScvO2、SOFA评分、APACHEⅡ评分等指标治疗前后相比,差异有统计学意义(P＜0.05)；治疗后组间相比,差异有统计学意义(P＜0.05).第7h尿量观察组大于对照组,2组比较差异有统计学意义(P＜0.05)；住ICU时间观察组短于对照组,2组比较差异有统计学意义(P＜0.05)；住院病死率观察组为15.00％,对照组为52.50％,2组比较差异有统计学意义(P＜0.05).结论 早期目标导向疗法可显著改善血流动力学指标及APACHEⅡ评分、器官衰竭评分(SOFA),可降低病死率.

Clinical observation of 40 cases with severe septic shock treated by early goal-directed therapy

OBJECTIVE To observe the effect of early goal-directed therapy(EGDT)of septic shock.METHODS 80 patients with septic shock were randomly divided into the observation group and the control group,with 40 cases in each group.The control group had conventional treatment,and the observation group had EGDT.RESULTS There were significant differences of CVP,MAP,ScvO2,SOFA,APACHE score and other indexes before and after the treatment(P﹤0.05);After the treatment,there was a significantly difference between the 2 group(P﹤0.05).At seventh hour,urine volume of the observation group was larger than that of the control group(P﹤0.05);ICU time of the observation group was shorter than the of the control group(P﹤0.05);mortality rate in the treatment group was 15%,and it was 52.50% in the control group(P﹤0.05).CONCLUSION Early goal-directed therapy can significantly improve the hemodynamic indexes and APACHE II score,organ failure score(SOFA),which can reduce the mortality rate.