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目的观察液体复苏对严重脓毒症和脓毒症休克患者的影响。方法将符合纳入标准的41例脓毒症患者分为2组,试验组18例使用液体复苏,对照组23例不使用液体复苏。比较2组患者的28 d生存率、急诊重症病房(EICU)住院时间和康复情况。结果 2组住院天数、28 d生存率、多器官功能障碍综合征(MODS)发生率、急性肾功能衰竭(ARF)发生率和辅助通气率比较差异均无统计学意义(P>0.05)。结论液体复苏作为一种常用的治疗手段,确实延长了脓毒症患者的在院生存天数,但患者28 d后生存率并未显著降低。不能得出患者的生存率和液体复苏治疗方案的采用有直接关系或者与MODS的发生率有直接关系的结论。采取液体复苏究竟能否改善严重脓毒症患者预后,还需要更多随机临床对照试验样本进一步证明。
Objective To investigate the effect of fluid resuscitation on patients with severe sepsis and septic shock. Methods Forty-one patients with sepsis who met the inclusion criteria were divided into two groups. Liquid resuscitation was performed in 18 patients in the test group and liquid resuscitation was not used in 23 patients in the control group. The 28-day survival rate, hospital stay and rehabilitation of emergency intensive care unit (EICU) were compared between the two groups. Results There was no significant difference in days of hospitalization, survival at 28 days, incidence of multiple organ dysfunction syndrome (MODS), incidence of acute renal failure (ARF) and assisted ventilation (P> 0.05). Conclusion Liquid resuscitation as a commonly used treatment method indeed prolongs the survival days in sepsis patients, but the survival rate of patients after 28 days has not significantly decreased. It can not be concluded that the survival rate of a patient is directly related to the adoption of a liquid resuscitation regimen or directly related to the incidence of MODS. Whether liquid resuscitation can improve the prognosis of patients with severe sepsis, but also more randomized controlled clinical trial samples to further prove.