硝酸甘油对脓毒性休克患者复苏达标后微循环的影响

发布时间：2018-05-15 12:18

本文选题：硝酸甘油 + 休克　；参考：《解放军医学杂志》2016年06期

【摘要】：目的评价硝酸甘油对脓毒性休克患者复苏达标后微循环及病死率的影响。方法选取2014年1月-2015年1月兰州大学第一医院重症医学科收治的符合脓毒性休克标准的患者,休克复苏达标后随机分为对照组和硝酸甘油组。对照组给予标准治疗,硝酸甘油组在标准治疗基础上,给予硝酸甘油0.5~1.0mg/h静脉泵入。入组后监测两组患者治疗后0、6、24、72h时的舌下微循环指标,包括小血管总密度(TVDs)、灌注小血管密度(PVDs)、灌注小血管比例(PPVs)、微血管流量指数(MFI)、异质性指数。记录患者ICU住院时间、总住院时间及随访28d病死率。结果入组53例患者,其中对照组26例,硝酸甘油组27例。治疗24、72h两组患者TVDs均未明显增加,而PVDs、PPVs、MFI、异质性指数在治疗6、24、72h时较入组时提高,治疗24、72h较6h明显升高。硝酸甘油组治疗72h各微循环指标明显高于对照组(P0.05),机械通气时间明显低于对照组(P0.05),ICU住院时间及总住院时间明显短于对照组(P0.05),住院病死率及28d病死率均低于对照组(P0.05)。结论硝酸甘油对感染性休克复苏达标后患者微循环有显著改善作用,并可有效改善患者预后,降低机械通气时间、ICU停留时间、总住院时间以及病死率。
[Abstract]:Objective to evaluate the effect of nitroglycerin on microcirculation and mortality of septic shock patients after resuscitation. Methods from January 2014 to January 2015, patients with septic shock were randomly divided into control group and nitroglycerin group after shock resuscitation. The control group was given standard treatment, and the nitroglycerin group received intravenous infusion of nitroglycerin 0.5~1.0mg/h on the basis of standard treatment. The indexes of sublingual microcirculation, including total density of small blood vessel, perfusion of small vessel density and PVDsn, perfusion of small vessel ratio, microvascular flow index (MFI) and heterogeneity index, were monitored at 0 ~ 6 ~ 24 ~ 72 h after treatment. The ICU hospitalization time, total hospitalization time and fatality rate of 28 days follow-up were recorded. Results there were 53 patients in the group, 26 in the control group and 27 in the nitroglycerin group. TVDs was not significantly increased in both groups at 24 ~ 72 h after treatment, but the heterogeneity index of PVD was significantly increased at 72 h after treatment, and increased significantly at 24 h after treatment and 6 h after treatment. The indexes of microcirculation in nitroglycerin group were significantly higher than those in control group at 72 h, and the mechanical ventilation time was significantly lower than that in control group (P 0.05). The hospitalization time and total hospitalization time of nitroglycerin group were significantly shorter than that of control group (P 0.05). The fatality rate and fatality rate of 28 days were lower than that of control group (P 0.05). Conclusion nitroglycerin can significantly improve the microcirculation of patients with septic shock after resuscitation, and can effectively improve the prognosis of patients, reduce the mechanical ventilation time and ICU stay time, total hospitalization time and mortality.
【作者单位】：兰州大学第一医院重症医学科;
【基金】：兰州大学第一医院院内基金(ldyyynlc201110)~~
【分类号】：R459.7

【相似文献】