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目的：观察超量扩容、快速脱水、早期强心３项措施在小儿感染性休克治疗中的疗效。方法：将９８例小儿感染性休克患儿按２∶１随机分为甲组６５例，乙组３３例，甲组以２∶１液（用０．９％盐水２份与１．４％碳酸氢钠１份组成）加５％碳酸氢钠及６％低分子右旋糖酐等大量快速扩容；以２０％甘露醇、速尿快速脱水，以西地兰、川芎嗪注射液早期强心治疗。乙组按感染性休克常规治疗，以２∶１液或６％低分子右旋糖酐１０～２０ｍｌ／ｋｇ快速扩容，仅在发现脑水肿指征时给脱水剂，在出现心力衰竭指征时给强心剂；２组抗生素、血管活性药、地塞米松及能量合剂等综合治疗措施完全相同。结果：甲组治愈率８７．６９％，乙组为６０．６１％（Ｐ＜０．０１）；甲组有尿时间（１．８７±１．０２）小时，血压恢复正常时间（１．８４±０．７９）小时，脉搏及心跳有力时间（１．９０±０．８１）小时，四肢转温时间（２．５１±０．３６）小时，均较乙组为快（Ｐ均＜０．０１）。结论：对小儿感染性休克采取的３项改进措施疗效明显。
Objective: To observe the effects of overdosing, rapid dehydration and early cardiac covariance in the treatment of septic shock in children. Methods: 98 children with septic shock were randomly divided into two groups according to 2: 1: 65 cases in group A, 33 cases in group B. Group A was treated with 2: 1 solution of 0.9% saline and 1.4% Sodium hydrogen 1 part composition) plus 5% sodium bicarbonate and 6% low molecular weight dextran and other rapid expansion; 20% mannitol, furosemide rapid dehydration, cedilanid, ligustrazine injection early cardiac treatment. Group B was routinely treated for septic shock with 2: 1 solution or 6% dextran 10 ~ 20ml / kg rapid expansion, only to find signs of cerebral edema dehydration agent, in the event of cardiac failure to give the indication of cardiac; 2 groups of antibiotics, vasoactive drugs, dexamethasone and energy mixture and other comprehensive treatment measures are identical. Results: The cure rate of group A was 87.69%, group B was 60.61% (P <0.01); group A had urine hours (1.87 ± 1.02) hours, blood pressure returned to normal time (1.84 ± 0.79) hours, pulse and heartbeat time (1.90 ± 0.81) hours, limbs warming time (2.51 ± 0.36) hours, were faster than those in group B (all P <0. 01). Conclusion: The three improvements in septic shock in children have obvious curative effect.