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目的:研究早期目标导向治疗(EGDT)和山莨菪碱对重度脓毒症患者预后的影响。方法:将2010年10月至2012年10月收住ICU的18岁以上重度脓毒症患者63例随机分配为治疗(EGDT和山莨菪碱)组和常规治疗对照组,比较两组24 h乳酸清除率,序贯器官衰竭估计(SOFA)评分的变化及血管活性药物使用时间、28 d机械通气时间、ICU停留时间和28 d病死率。结果:治疗组入选后24 h乳酸清除率明显高于对照组,3d和7d SOFA评分均明显低于对照组,治疗组血管活性药物使用时间、28 d内机械通气时间、ICU停留时间和28 d病死率均明显少于对照组,P均<0.05。结论:早期目标导向治疗和山莨菪碱可明显改善重度脓毒症患者的预后。
Objective: To investigate the effects of early goal-directed therapy (EGDT) and anisodamine on the prognosis of patients with severe sepsis. Methods: Sixty-three patients with severe sepsis who received ICU from October 2010 to October 2012 were randomly assigned to treatment group (EGDT and anisodamine) and conventional treatment control group. The levels of 24 h lactate Clearance, sequential organ failure assessment (SOFA) score, duration of vasoactive drug use, duration of mechanical ventilation at 28 days, ICU stay, and mortality at 28 days. Results: The lactic acid clearance rate of the treatment group at 24 h after admission was significantly higher than that of the control group. The SOFA scores at 3d and 7 d were significantly lower than those in the control group. The duration of vasoactive drug use, the duration of mechanical ventilation within 28 days, the ICU stay and 28 d Mortality were significantly less than the control group, P <0.05. Conclusion: Early target-directed therapy and anisodamine can significantly improve the prognosis of patients with severe sepsis.