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目的研究液体平衡状态与儿童脓毒性休克预后的关系,以便指导治疗并帮助判断预后。方法44例脓毒性休克患儿,开始抗休克治疗时进行小儿危重症评分,监测每日液体平衡状态,比较不同液体平衡状态与患儿预后的关系。结果开始抗休克治疗的5 d内发生液体负平衡组27例,25例存活;液体正平衡组17例,9例存活,液体负平衡组存活率明显高于正平衡组(P<0.01)。存活患儿有5例液体负平衡出现在治疗第1天,12例出现在第2天,5例出现在第3天,1例出现在第4天,2例出现在第5天,存活患儿液体负平衡多数发生在抗休克治疗的前3 d。结论脓毒性休克患儿抗休克治疗的前5 d内发生液体负平衡提示预后良好。
Objective To study the relationship between fluid homeostasis and the prognosis of childhood septic shock in order to guide the treatment and help to judge the prognosis. Methods Forty-four children with septic shock were screened for critical care in children with anti-shock therapy. Daily fluid balance was monitored, and the relationship between different fluid balance and prognosis was compared. Results In the first 5 days after anti-shock treatment, 27 patients with negative fluid balance group and 25 patients survived. The fluid positive balance group (n = 17) and the 9 patients survived (n = 9). The survival rate of the negative fluid group was significantly higher than that of the positive balance group (p <0.01). Five of the surviving children presented with negative fluid balance on day 1 of treatment, 12 on day 2, 5 on day 3, 1 on day 4 and 2 on day 5, surviving The majority of liquid negative balance occurred in the first 3 days of anti-shock treatment. Conclusions The negative balance of fluid in the first 5 days of anti-shock therapy in children with septic shock suggests a good prognosis.