感染性休克患者输血治疗的有效性研究

发布时间：2018-05-20 20:32

本文选题：感染性休克 + 输血　；参考：《中华医院感染学杂志》2016年06期

【摘要】：目的探讨感染性休克患者输血治疗的有效性,为感染性休克的治疗提供参考依据。方法选取2010年1月-2015年6月住院治疗的感染性休克患者60例,随机分为输血组与未输血组各30例,给予治疗原发病、纠正酸中毒及电解质紊乱、抗感染、利尿、强心等基础治疗,输血组同时输注全血200~400ml;记录患者复苏24h时液体总量、每小时尿量、中心静脉压(CVP)、平均动脉压(MAP)、心输出量(CO)、全心舒张末期容积指数(GEDVI),复苏前及复苏3d时患者血清降钙素原(PCT)、C-反应蛋白(CRP)水平变化,肺水肿发生率及28d内病死率。结果两组复苏24h时每小时尿量、CVP、MAP、GEDVI均较复苏前明显改善(P0.05),输血组复苏24h时液体总量少于未输血组(P0.05),每小时尿量多于未输血组(66.08±54.83)ml(P0.05);两组复苏3d时血清PCT、CRP均较复苏前明显下降(P0.05),输血组复苏3d时血清PCT、CRP低于未输血组;输血组与未输血组肺水肿发生率分别为6.67%、13.33%,比较差异无统计学意义,28d内病死率输血组为0,未输血组为16.67%,差异均有统计学意义(P0.05)。结论感染性休克患者在常规液体复苏基础上适当进行输血治疗,可减少输液总量,增强机体抗炎症反应能力,有利于降低病死率。
[Abstract]:Objective to investigate the effectiveness of transfusion therapy in patients with septic shock and to provide reference for the treatment of septic shock. Methods from January 2010 to June 2015, 60 patients with septic shock were randomly divided into two groups: transfusion group (n = 30) and non-transfusion group (n = 30). For basic therapy such as strengthening the heart, the whole blood was injected into the blood transfusion group at the same time. The total volume of fluid and the volume of urine per hour during 24 hours of resuscitation were recorded. Central venous pressure (CVP), mean arterial pressure (MAPP), cardiac output (CPV), total cardiac end-diastolic volume index (TVEI), serum procalcitonin (PCT) C-reactive protein (CRP) level, pulmonary edema rate and fatality rate within 28 days were observed before resuscitation and 3 days after resuscitation. Results after 24 hours of resuscitation, the urine volume per hour in both groups was significantly improved compared with that before resuscitation. The total volume of fluid in the transfusion group during 24 hours of resuscitation was lower than that in the non-transfusion group, and the volume of urine per hour was higher than that in the non-transfusion group (66.08 卤54.83ml / h), and the serum levels of PCTCRP in the two groups were significantly higher than those before resuscitation after 3 days of resuscitation. After 3 days of resuscitation, the level of serum PCT CRP in the blood transfusion group was lower than that in the non-transfusion group. The incidence of pulmonary edema in transfusion group and non-transfusion group were 6.67 and 13.33, respectively. There was no significant difference in mortality within 28 days between transfusion group (0) and non-transfusion group (16.67). The difference was statistically significant (P 0.05). Conclusion Transfusion therapy on the basis of conventional fluid resuscitation in patients with septic shock can reduce the amount of infusion, enhance the ability of anti-inflammatory reaction, and reduce the mortality.
【作者单位】：濮阳市人民医院输血科;濮阳市妇幼保健院妇产科;
【基金】：河南省科技厅基金资助项目(XF250163)
【分类号】：R459.7

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