【摘要】 目的 观察小剂量血管加压素对感染性休克患者血乳酸水平及肾衰竭进展的影响。方法 受试患者来自淄博市中心医院,纳入时间为2015-05～2017-08,均诊治为感染性休克患者100例,随机将其分成两组,两组均给予一致的扩容、抗生素、营养支持、去甲肾上腺素等基础治疗措施,其中一组联合给予小剂量血管加压素治疗(观察组),另一组设为对照组。分析治疗后不同时点血乳酸水平、肾功能指标、血流动力学指标、组间ICU住院时间和住院期间病死率的差异。结果 治疗后两组血乳酸水平呈逐渐下降趋势,各时点水平均较治疗前差异有统计学意义(P<0.05),但治疗后观察组的血乳酸水平在各时点均明显低于对照组,差异有统计学意义(P<0.05)。治疗24 h后两组血肌酐(SCr)、血清尿素(BUN)水平均继续上升,但观察组上升幅度明显小于对照组(P<0.05);两组尿量较治疗前增多,在治疗24 h后观察组肾功能指标均明显优于对照组,差异有统计学意义(P<0.05)。治疗24 h后两组MAP均上升、HR均下降,较治疗前差异均有统计学意义(P<0.05),CO值变化微小(P>0.05),治疗后观察组在MAP和HR上的改善程度较对照组大,差异有统计学意义(P<0.05)。两组ICU住院时间长度相当,住院期间均有部分患者死亡,病死率差异无统计学意义(P>0.05)。结论 在基础治疗感染性休克患者基础上,小剂量血管加压素可用于联合治疗方案中,其可改善患者血乳酸水平,降低肾衰竭程度。更多还原

【Abstract】 Objective To compare the effect of low dose vasopressin on the level of blood lactic acid and the progression of renal failure in patients with septic shock.Methods One hundred patients with septic shock from May 2015 to August 2017 were randomly divided into two groups.The two groups were given a consistent expansion,antibiotics,nutritional support,norepinephrine and other basic treatment measures.One group was treated with a small dose of vasopressin(observation group).The other group was set as a control group.After treatment,the difference of serum lactic acid level,renal function index,hemodynamic index,ICU time of hospitalization and mortality during hospitalization at different time in two groups were analyzed.Results After treatment,the level of blood lactic acid decreased gradually in the two groups.But after treatment,the level of blood lactate in the observation group was significantly lower than that of the control group at all time points,and the differences were statistically significant(P<0.05).After the treatment of 24 h,the level of SCr and BUN continued to rise in two groups.But the increase of the observation group was significantly smaller than that of the control group(P <0.05).The amount of urine in the two groups was more than that before the treatment;after the treatment of 24 h,the indexes of renal function in the observation group were obviously superior to those of the control group,and the differences were statistically significant.After the treatment of 24 h,both groups of MAP increased and HR decreased in all two groups,the difference was statistically significant compared with that before treatment(P < 0.05).CO value did not change significantly(P > 0.05).After treatment,the improvement of MAP and HR in the observation group was larger than that of the control group(P <0.05).The time of ICU hospitalization in the two groups was consistent.Some patients died during the hospital stay,and there was no statistically significant difference in mortality(P > 0.05).Conclusion Vasopressin can be used in combined treatment regimens in patients with septic shock for basic therapeutic treatment.更多还原