基于早期集束化治疗中应用参附注射液对脓毒性休克的治疗效果探讨
|
摘要
目的:探讨基于早期集束化治疗中应用参附注射液对脓毒性休克的治疗效果。方法:选择2017-05—2018-05期间本院收治的92例脓毒性休克患者作为研究对象,根据随机数字表法将92例患者分为观察组(n=48)和对照组(n=44),观察组患者予以基于早期集束化治疗中应用参附注射液治疗,对照组患者予以常规治疗,分别监测两组患者治疗前(T0)及治疗后6h(T1)、24h(T2)全心舒张末容积指数(GEDVI)、中心静脉压(CVP)、血管外肺水指数(EVLWI)、体循环血管阻力指数(SVRI)、每搏输出指数(SVI)、乳酸(Lac)水平变化情况。结果:T0时,两组患者的GEDVI、CVP、EVLWI、SVRI、SVI、Lac水平比较,差异无统计学意义(P>0.05);T1时,观察组的GEDVI、CVP、SVI水平均明显高于对照组,Lac水平明显低于对照组,均差异有统计学意义(P<0.05);T2时,观察组及对照组的GEDVI、CVP、SVI、Lac水平比较,差异无统计学意义(P>0.05)。T1、T2时,两组患者的SVRI水平比较,均差异无统计学意义(均P>0.05)。T1时,两组患者的EVLWI水平比较,差异无统计学意义(P>0.05);T2时,观察组的EVLWI水平明显低于对照组,差异有统计学意义(P<0.05)。结论:基于早期集束化治疗中应用参附注射液治疗脓毒性休克,可有效改善患者的循环灌注,减轻液体潴留,对改善患者的预后具有十分重要的意义。
Objective:To investigate the therapeutic effect of Shenfu injection on septic shock based on early clustering therapy.Method:Ninty-two patients with septic shock admitted to our hospital from May 2017 to May2018were selected as subjects,According to the random number table method,92 patients were divided into observation group(n=48cases)and control group(n=44cases).Patients in the observation group were treated with Shenfu injection based on early cluster treatment,and patients in the control group were given routine treatment,respectively.Total diastolic volume index(GEDVI),central venous pressure(CVP),extravascular lung water index(EVLWI),systemic vascular resistance index(SVRI),stroke output index(SVI),lactate(lactate,Lac)levels were detected in two groups of patients before treatment(T0)and 6hafter treatment(T1),24h(T2).Result:At T0,there were no significant differences in GEDVI,CVP,EVLWI,SVRI,SVI,and Lac levels between the two groups(P>0.05).At T1,the levels of GEDVI,CVP and SVI in the observation group were significantly higher than those in the control group,and the level of Lac was significantly lower than that in the control group(P<0.05).At T2,there is no significant differences in levels of GEDVI,CVP,SVI and Lac between the observation group and the control group(P>0.05).At T1 and T2,there was no significant difference in SVRI between the two groups(P>0.05).At T1,there was no significant difference in EVLWI levels between the two groups(P>0.05).At T2,the EVLWI level in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:The application of Shenfu injection in the treatment of septic shock based on early clustering therapy can effectively improve the patient's circulatory perfusion and reduce fluid retention and significantly improve the prognosis of patients.
Objective:To investigate the therapeutic effect of Shenfu injection on septic shock based on early clustering therapy.Method:Ninty-two patients with septic shock admitted to our hospital from May 2017 to May2018were selected as subjects,According to the random number table method,92 patients were divided into observation group(n=48cases)and control group(n=44cases).Patients in the observation group were treated with Shenfu injection based on early cluster treatment,and patients in the control group were given routine treatment,respectively.Total diastolic volume index(GEDVI),central venous pressure(CVP),extravascular lung water index(EVLWI),systemic vascular resistance index(SVRI),stroke output index(SVI),lactate(lactate,Lac)levels were detected in two groups of patients before treatment(T0)and 6hafter treatment(T1),24h(T2).Result:At T0,there were no significant differences in GEDVI,CVP,EVLWI,SVRI,SVI,and Lac levels between the two groups(P>0.05).At T1,the levels of GEDVI,CVP and SVI in the observation group were significantly higher than those in the control group,and the level of Lac was significantly lower than that in the control group(P<0.05).At T2,there is no significant differences in levels of GEDVI,CVP,SVI and Lac between the observation group and the control group(P>0.05).At T1 and T2,there was no significant difference in SVRI between the two groups(P>0.05).At T1,there was no significant difference in EVLWI levels between the two groups(P>0.05).At T2,the EVLWI level in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:The application of Shenfu injection in the treatment of septic shock based on early clustering therapy can effectively improve the patient's circulatory perfusion and reduce fluid retention and significantly improve the prognosis of patients.
引文
[1]蔡国龙,严静.《中国严重脓毒症/脓毒性休克治疗指南》背景介绍[J].中华重症医学电子杂志,2016,2(1):40-42.
[2]童洪杰,胡才宝,吕晓春,等.《中国严重脓毒症/脓毒性休克治疗指南》:如何看待早期目标导向治疗[J].中华重症医学电子杂志,2016,2(1):36-39.
[3]李红.不同时机进行早期目标导向治疗对脓毒性休克预后的影响[J].新乡医学院学报,2014,31(9):745-746.
[4]王枭,杨德兴,李雪娇,等.集束化治疗对脓毒性休克恒河猴心肌损伤、血流动力学的影响[J].昆明医科大学学报,2014,35(4):10-12.
[5]赖志珍,孟建标,胡马洪,等.参附注射液对脓毒性休克低心排患者血流动力学和心肌损伤标志物的影响[J].浙江中西医结合杂志,2018,28(8):641-644.
[6]陈如杰,郭献阳,程碧环,等.阿托伐他汀对脓毒性休克患者的心肺保护作用[J].中华危重症医学杂志(电子版),2015,8(5):291-295.
[7]何木龙,陈少军.参附注射液治疗休克(厥脱证)38例的临床观察[J].实用中西医结合临床,2016,16(1):20-22.
[8]刘晓,刘志广,范志松,等.严重脓毒症与脓毒性休克患者预后分析[J].山东大学学报(医学版),2016,54(10):80-84.
[9] Myburgh JA,Mythen MG.Resuscitation fluids[J].N Engl J Med,2013,369(13):1243-1251.
[10]唐锦华.集束化治疗依从性及对严重脓毒症和脓毒性休克患者病死率影响的探讨[J].齐齐哈尔医学院学报,2017,38(4):419-420.
[11]中国医师协会急诊医师分会.中国研究型医院学会休克与脓毒症专业委员会.参附注射液急重症临床应用专家共识[J].临床急诊杂志,2018,19(10):651-657.
[12]王龙廷,周荣斌.脓毒性休克预后相关生物学指标的研究进展[J].中国全科医学,2016,19(4):492-496.
[13]何荣,孔立.参附注射液治疗感染性休克的临床研究[J].陕西中医,2016,37(4):424-425.
[14]郭祯祯.参附注射液在脓毒症休克早期对血流动力学的影响[D].济南:山东中医药大学,2014.
[15]傅声武,龚仕金,吴国伟,等.参附注射液对脓毒症休克血流动力学的影响[J].全科医学临床与教育,2014,12(6):682-684.
[16]吴凡伟,周仙仕,熊倩.中医药治疗脓毒性休克辨证处方规律及临床疗效总结[J].辽宁中医药大学学报,2016,18(12):168-171.
[17]王文龙.参附注射液治疗脓毒性休克作用机理分析[J].新中医,2015,47(3):3-5.
[18]郝浩,孔立,韩宁,等.参附注射液对脓毒性休克血流动力学及多糖包被的影响[J].中成药,2017,39(11):2437-2440.
[2]童洪杰,胡才宝,吕晓春,等.《中国严重脓毒症/脓毒性休克治疗指南》:如何看待早期目标导向治疗[J].中华重症医学电子杂志,2016,2(1):36-39.
[3]李红.不同时机进行早期目标导向治疗对脓毒性休克预后的影响[J].新乡医学院学报,2014,31(9):745-746.
[4]王枭,杨德兴,李雪娇,等.集束化治疗对脓毒性休克恒河猴心肌损伤、血流动力学的影响[J].昆明医科大学学报,2014,35(4):10-12.
[5]赖志珍,孟建标,胡马洪,等.参附注射液对脓毒性休克低心排患者血流动力学和心肌损伤标志物的影响[J].浙江中西医结合杂志,2018,28(8):641-644.
[6]陈如杰,郭献阳,程碧环,等.阿托伐他汀对脓毒性休克患者的心肺保护作用[J].中华危重症医学杂志(电子版),2015,8(5):291-295.
[7]何木龙,陈少军.参附注射液治疗休克(厥脱证)38例的临床观察[J].实用中西医结合临床,2016,16(1):20-22.
[8]刘晓,刘志广,范志松,等.严重脓毒症与脓毒性休克患者预后分析[J].山东大学学报(医学版),2016,54(10):80-84.
[9] Myburgh JA,Mythen MG.Resuscitation fluids[J].N Engl J Med,2013,369(13):1243-1251.
[10]唐锦华.集束化治疗依从性及对严重脓毒症和脓毒性休克患者病死率影响的探讨[J].齐齐哈尔医学院学报,2017,38(4):419-420.
[11]中国医师协会急诊医师分会.中国研究型医院学会休克与脓毒症专业委员会.参附注射液急重症临床应用专家共识[J].临床急诊杂志,2018,19(10):651-657.
[12]王龙廷,周荣斌.脓毒性休克预后相关生物学指标的研究进展[J].中国全科医学,2016,19(4):492-496.
[13]何荣,孔立.参附注射液治疗感染性休克的临床研究[J].陕西中医,2016,37(4):424-425.
[14]郭祯祯.参附注射液在脓毒症休克早期对血流动力学的影响[D].济南:山东中医药大学,2014.
[15]傅声武,龚仕金,吴国伟,等.参附注射液对脓毒症休克血流动力学的影响[J].全科医学临床与教育,2014,12(6):682-684.
[16]吴凡伟,周仙仕,熊倩.中医药治疗脓毒性休克辨证处方规律及临床疗效总结[J].辽宁中医药大学学报,2016,18(12):168-171.
[17]王文龙.参附注射液治疗脓毒性休克作用机理分析[J].新中医,2015,47(3):3-5.
[18]郝浩,孔立,韩宁,等.参附注射液对脓毒性休克血流动力学及多糖包被的影响[J].中成药,2017,39(11):2437-2440.