不同换泵方案对感染性休克患者血压的影响分析

发布时间：2018-04-09 11:25

本文选题：感染性休克　切入点：去甲肾上腺素　出处：《中华医院感染学杂志》2017年16期

【摘要】：目的探讨感染性休克患者采用双泵双通路和双泵单通路对于血管活性药物注射泵更换期间的血压变化。方法选取2015年1月-2016年12月医院住院治疗的感染性休克患者112例,采用随机数字表法将112例患者随机分为双通路组和单通路组,每组各56例;两组患者均给予常规对症治疗和液体复苏,双通路组和单通路组分别采用双泵双通路和双泵单通路换泵方式;采集患者标本,进行菌株鉴定;记录患者血流动力学基本稳定时的收缩压、血压波动最大幅度和血压波动时间;记录两组治疗期间不良反应发生情况。结果双通路组56例患者分离出病原菌62株,其中革兰阴性菌43株占69.35%,革兰阳性菌16株占25.81%,真菌3株占4.84%,单通路组56例患者分离出病原菌64株,其中革兰阴性菌41株占64.06%,革兰阳性菌19株占29.69%,真菌4株占6.25%,双通路组和单通路组病原菌构成比较差异无统计学意义;双通路组和单通路组初始收缩压比较差异无统计学意义;单通路组血压波动最大幅度和血压波动时间均显著低于双通路组(P0.01);双通路组和单通路组不良反应发生率比较差异无统计学意义。结论与双泵双通路换泵方式相比,双泵单通路换泵方式可降低感染性休克患者血压波动,可以考虑作为血管活性药物的标准换泵方式。
[Abstract]:Objective to investigate the changes of blood pressure during the replacement of vasoactive drug injection pump in patients with septic shock.Methods 112 patients with septic shock who were hospitalized from January 2015 to December 2016 were randomly divided into two groups (56 cases in each group).The patients in both groups were given routine symptomatic therapy and fluid resuscitation.The systolic blood pressure, the maximum fluctuation of blood pressure and the time of blood pressure fluctuation were recorded when hemodynamics was basically stable.Results Sixty-two strains of pathogenic bacteria were isolated from 56 patients in the double pathway group, of which 43 were Gram-negative bacteria (69.35), 16 Gram-positive bacteria (25.81), 3 fungi (4.84), and 64 (single pathway) 56 patients.Among them, 41 strains of Gram-negative bacteria accounted for 64.06%, 19 strains of Gram-positive bacteria accounted for 29.69%, 4 strains of fungi accounted for 6.25%. There was no significant difference in the composition of pathogens between the two pathway groups and the single pathway group, and there was no significant difference in the initial systolic blood pressure between the two pathway groups and the single pathway group.The maximum amplitude of blood pressure fluctuation and the time of blood pressure fluctuation in single pathway group were significantly lower than those in double pathway group (P 0.01), and there was no significant difference in the incidence of adverse reactions between double pathway group and single pathway group.Conclusion compared with double pump and double pathway, double pump single pathway can reduce the fluctuation of blood pressure in septic shock patients, which can be considered as the standard pump changing method of vasoactive drugs.
【作者单位】：牡丹江医学院附属红旗医院重症医学科;牡丹江医学院附属红旗医院神经外科;
【分类号】：R459.7

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