RASS评分对感染性休克患者改良早期目标导向治疗的探讨

发布时间：2018-03-04 01:08

本文选题：RASS评分　切入点：感染性休克　出处：《中华医院感染学杂志》2016年19期 　论文类型：期刊论文

【摘要】：目的探讨RASS评分对感染性休克患者改良早期目标导向治疗(EGDT)的价值,以指导临床治疗。方法选取2013年10月-2015年6月医院ICU收治的感染性休克患者92例,按照随机数字表法分为试验组和对照组,每组各46例,试验组采用RASS评分指导镇静+改良EGDT,对照组采用常规镇静+EGDT,观察28d,比较两组患者机械通气时间、住ICU时间、总费用、病死率和多器官功能障碍综合征(MODS)发生率,并观察两组患者6、24h输液量,测定治疗前后肝功能、肾功能指标变化。结果试验组患者机械通气时间、入住ICU时间和住院总费用,均明显低于对照组患者,差异有统计学意义(P0.05);试验组患者28d病死率和MODS发生率分别为15.2%和34.8%,显著低于对照组患者41.3%和60.9%,差异有统计学意义(P0.05);试验组患者6、24h输液总量显著高于对照组;两组患者治疗前后肝功能和肾功能指标呈现先升高后下降趋势,在治疗后24h达到最大值。结论 RASS评分对感染性休克患者EGDT具有很大的指导价值,能缩短患者机械通气时间,减少病死率,改善患者预后。
[Abstract]:Objective to evaluate the value of RASS score in the treatment of septic shock patients with modified early goal-oriented therapy. Methods 92 patients with septic shock admitted to ICU from October 2013 to June 2015 were selected. According to the random digital table method, the patients were divided into the experimental group and the control group with 46 cases in each group. The experimental group used RASS score to guide the sedation improved EGDT.The control group was treated with routine sedation and observed for 28 days. The duration of mechanical ventilation, residence time of ICU, total cost were compared between the two groups. The mortality rate and the incidence of multiple organ dysfunction syndrome (MODS) were observed. The volume of infusion at 6h and the changes of liver function and renal function before and after treatment were observed. Results the time of mechanical ventilation, the time to stay in ICU and the total cost of hospitalization were measured in the experimental group. All of them were significantly lower than those in the control group. The fatality rate and MODS incidence in the trial group were 15.2% and 34.8, respectively, which were significantly lower than those in the control group (41.3% and 60.9, P 0.05), and the total infusion volume in the test group was significantly higher than that in the control group. Before and after treatment, the indexes of liver function and renal function in both groups increased first and then decreased, and reached the maximum at 24 hours after treatment. Conclusion RASS score has great guiding value for EGDT in patients with septic shock and can shorten the time of mechanical ventilation in patients with septic shock. Reduce the mortality and improve the prognosis of patients.
【作者单位】：威海市立医院重症医学科;
【基金】：山东省卫生厅基金资助项目(SW-2012B029)
【分类号】：R459.7

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