摘要
目的:探讨参附注射液在重症肺炎并发感染性休克早期液体复苏中的应用效果。方法:选取2020年6月-2022年6月新余市人民医院收治的80例重症肺炎并发感染性休克患者,采用随机数字表法分为研究组和对照组,各40例。两组均按早期复苏目标导向治疗(EGDT)方案复苏,对照组采用0.9%氯化钠注射液复苏,在此基础上研究组加用参附注射液复苏。比较两组血流动力学参数[心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)]、微循环指标[乳酸清除率、混合静脉氧饱和度(SvO_(2))、中心静脉氧饱和度(ScvO_(2))]、慢性健康状况评分系统Ⅱ(APACHEⅡ)评分及脑钠肽(BNP)水平。结果:两组复苏6、24 h的HR均较复苏前下降(P<0.05)。研究组复苏6、24 h的MAP和CVP均较复苏前上升(P<0.05)。研究组复苏6、24 h的HR均低于对照组,MAP和CVP均高于对照组(P<0.05)。对照组复苏24 h的MAP、CVP均高于复苏前(P<0.05)。两组复苏6、24 h的乳酸清除率均较复苏前上升(P<0.05)。研究组复苏6、24 h的ScvO_(2)及SvO_(2)均高于复苏前(P<0.05)。研究组6、24 h的乳酸清除率、ScvO_(2)、SvO_(2)均高于对照组(P<0.05)。对照组复苏24 h的ScvO_(2)、SvO_(2)均高于复苏前(P<0.05)。研究组复苏6、24 h的APACHEⅡ评分均较复苏前下降,对照组复苏24 h的APACHEⅡ评分低于复苏前(P<0.05)。研究组复苏6、24 h的APACHEⅡ评分均低于对照组(P<0.05)。两组复苏6 h的血清BNP水平均高于复苏前,两组复苏24 h的血清BNP水平均低于复苏前,且研究组复苏6、24 h的血清BNP水平均低于对照组(P<0.05)。结论:参附注射液能改善重症肺炎合并感染性休克患者的血流动力学状态及微循环,抑制BNP分泌,改善病情预后。
Objective:To explore the application effect of Shenfu Injection in early fluid resuscitation of severe pneumonia complicated with septic shock.Method:A total of 80 patients with severe pneumonia complicated with septic shock who were admitted to Xinyu People's Hospital from June 2020 to June 2022 were selected,they were divided into study group and control group according to random number table method,with 40 cases in each group.Both groups were resuscitated according to the early resuscitation goal-directed therapy(EGDT)scheme,the control group was resuscitated with 0.9%Sodium Chloride Injection,and the study group was additionally resuscitated with Shenfu Injection.The hemodynamic parameters[heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP)],microcirculation indicators[lactic acid clearance,SvO_(2),ScvO_(2)],the scores of chronic health status scoring systemⅡ(APACHEⅡ)and brain natriuretic peptide(BNP)levels were compared between the two groups.Result:HR of both groups at 6 and 24 h of resuscitation were lower than those before resuscitation(P<0.05).MAP and CVP of the study group at 6 and 24 h of resuscitation were higher than those before resuscitation(P<0.05).HR of the study group were lower than those of the control group at 6 and 24 h of resuscitation,while MAP and CVP were higher than those of the control group(P<0.05).MAP and CVP of control group at 24 h of resuscitation were higher than those before resuscitation(P<0.05).The lactic acid clearance rate of both groups at 6 and 24 h of resuscitation were higher than those before resuscitation(P<0.05).ScvO_(2) and SvO_(2) of the study group at 6 and 24 h of resuscitation were higher than those before resuscitation(P<0.05).The lactic acid clearance rate,ScvO_(2) and SvO_(2) of the study group at 6 and 24 h of resuscitation were higher than those of the control group(P<0.05).The ScvO_(2) and SvO_(2) levels of control group at 24 h of resuscitation were higher than those before resuscitation(P<0.05).APACHEⅡscores at 6 and 24 h of resuscitation of the study group were lower than those before resuscitation,and those at 24 h of resuscitation of the control group were lower than those before resuscitation(P<0.05).APACHEⅡscores of the study group at 6 and 24 h of resuscitation were lower than those of the control group(P<0.05).Serum BNP levels at 6 h of resuscitation of both groups were higher than those before resuscitation,serum BNP levels at 24 h of resuscitation of both groups were lower than those before resuscitation,and serum BNP levels at 6 and 24 h of the study group were lower than those of the control group(P<0.05).Conclusion:Shenfu Injection can improve the hemodynamic state and microcirculation of patients with severe pneumonia complicated with septic shock,inhibit the secretion of BNP,and improve the prognosis.
作者
沈锦明
SHEN Jinming(Xinyu People's Hospital,Jiangxi Province,Xinyu 338000,China)
出处
《中国医学创新》
CAS
2023年第10期88-92,共5页
Medical Innovation of China
基金
新余市科技计划项目(20193090810)。
关键词
参附注射液
重症肺炎
感染性休克
早期液体复苏
Shenfu Injection
Severe pneumonia
Septic shock
Early fluid resuscitation
