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目的评价不同液体用于老年感染性休克患者血管外肺水早期液体复苏的临床效果观察。方法选取2012年6月-2015年6月医院收取的老年感染性休克患者58例,随机分为试验组与对照组各29例。以早期复苏为根本性目标给予2组患者导向治疗,对照组仅予0.9%氯化钠溶液展开复苏治疗活动,试验组则予6%羟乙基淀粉130/0.4注射剂+0.9%氯化钠溶液展开复苏治疗活动,对2组复苏后6、24、48h液体复苏达标状况进行对比和记录。结果 2组复苏后血乳酸整体水平、血流动力学各项指标均有改善,与复苏前比较差异有统计学意义(P<0.05);试验组胸腔血容量指数达到升高指标的时长相对较对照组短,差异有统计学意义(P<0.05);试验组PVPI、EVLWI等指标复苏前后比较差异无统计学意义(P>0.05),对照组复苏48h后,其EVLWI显著上升,差异有统计学意义(P<0.05)。2组EVLWI和ITBVI、GEDVI、氧合指数等指标之间无相关性,和PVPI之间则呈现正相关。结论基于老年感染性休克患者而言,早期液体复苏有助于改善患者血流动力学,使之血管外肺水现象得到有效控制,可推广。
Objective To evaluate the clinical effects of different liquids for early resuscitation of extravascular lung water in elderly patients with septic shock. Methods Fifty-eight elderly patients with septic shock collected in our hospital from June 2012 to June 2015 were randomly divided into experimental group and control group with 29 cases each. Two groups of patients were given radical treatment based on early recovery. Patients in the control group were given only 0.9% sodium chloride solution for resuscitation. In the experimental group, 6% hydroxyethyl starch 130 / 0.4 injection + 0.9% sodium chloride solution The resuscitation and treatment activities were started, and the compliance of liquid resuscitation at 6, 24 and 48 hours after resuscitation was compared and recorded. Results After resuscitation, the levels of blood lactic acid and hemodynamics were all improved after resuscitation, which were significantly different from those before resuscitation (P <0.05). The duration of increase of thoracic blood volume index (P <0.05). There was no significant difference in PVPI and EVLWI between the two groups before and after resuscitation (P> 0.05). The EVLWI of the control group increased significantly after 48 hours resuscitation, the difference was statistically significant Significance (P <0.05). There was no correlation between EVLWI and ITBVI, GEDVI, oxygenation index and other indicators in 2 groups, and positively correlated with PVPI. Conclusion Based on the septic shock in elderly patients, early liquid resuscitation helps to improve the patient’s hemodynamics, so that extravascular lung water can be effectively controlled and can be generalized.