【摘要】 目的本研究评估不同MAP复苏目标对脓毒性休克患者器官功能的影响。方法回顾性调查241例成人脓毒性休克患者,根据复苏后MAP维持水平分为65~69 mmHg组、70~75 mmHg组、76~80mmHg组、>80 mmHg组。研究终点为MAP维持水平与器官功能之间的相关性。结果与MAP 65~69 mmHg组患者相比:MAP 70~75mmHg组和MAP 76~80 mmHg组出院时SOFA改善(P<0.05);MAP>80 mmHg组出院时APACHE II、MODS、SOFA均改善(P<0.05)。与MAP 70~75 mmHg组相比:MAP 76~80 mmHg组和MAP>80 mmHg组MODS评分变化改善(P<0.05)。MAP 76~80mmHg组和MAP>80 mmHg组相比,APACHE II、SOFA、MODS变化对比,P>0.05,差异无统计学意义。结论提高脓毒性休克患者初始复苏的MAP目标值,可能改善重要器官功能,但仍需要考虑其他个体化的因素。更多还原

【Abstract】 Objective The study aims to evaluate the effects of different MAP level goals on organ function in patients with septic shock.MethodsA retrospective study 214 patients with septic shock from intensive care unit was selected.According to MAP target level,the patients were divided into four groups,65~69 mmHg,70~75 mmHg,76~80 mmHg,>80 mmHg.The outcomes include function scores of main organs.Results Compared with MAP 65~69 mmHg,MAP 70~75 mmHg and MAP 76~80 mmHg led to a significantly more changes of SOFA score at discharge(P<0.05),and MAP>80 mmHg led to a significantly changes of APACHE II,MODS,and SOFA(P<0.05). Compared with MAP 70~76 mmHg,MAP 76~80 mmHg and MAP>80 mmHg led to a significantly more changes of MODS(P<0.05).There is no significant difference(P>0.05) about APACHE II,MODS,SOFA between MAP 76~80 mmHg and MAP>80 mmHg. Conclusion For patients with septic shock,higher MAP resuscitation level can lead to an improvement of organ function,but the individual factors must be considered in clinical practice.更多还原