早期液体复苏对感染性休克患者血流动力学的影响

目的：早期液体复苏对感染性休克患者血流动力学的影响。方法：选取2012年2月-2013年2月我院ICU收治的26例感染性休克患者作为研究对象，随机分为对照组和试验组，各13例。两组患者均采用PICCO监测，并根据早期复苏目标导向（Earlygoaldirectedtherapy，EGDT）进行早期液体复苏治疗。对照组和试验组复苏液分别为林格液和6％羟乙基淀粉130／0．4氯化钠溶液。分别于复苏开始时（Oh）、8h和24h收集患者的血流动力学参数。结果：两组患者CO及PAWP水平均随着时间的延长下降，而CI、CVP及SVR水平均随着时间的增加上升。除对照组CI外，与开始复苏（oh）相比较试验组和对照组的C0、CI、CVP、SVR及PAWP与开始复苏（O小时）相比较均有显著差异（P值均〈0．05）。经重复测量资料的．方差分析进行比较发现，与对照组相比较，试验组CVP和SVR上升水平及PAWP下降水平明显，差异具有统计学意义（P值均〈0．05）。结论：感染性休克患者使用6％羟乙基淀粉130／0．4氯化钠溶液进行复苏，能更好的改善患者的血流动力学指标。

Effects of Early Fluid Resuscitation on Hemodynamic Parameters in Septic Shock Patients

Objective： To study the effects of early fluid resuscitation on hemodynamic parameters in septic shock patients. Methods： From February 2012 to February 2013, 26 patients with septic shock were selected from ICU admission. Patients were randomly divided into control group （13 cases） and treatment group （13 cases）. PICCO monitoring was used, and early goal directed therapy （EGDT） was conducted for the early fluid resuscitation in all patients. Resuscitation fluids used in control and treatment group were ringer 6% 130/0.4 sodium chloride hydroxyethyl starch solution, respectively. Hemodynamic parameters were collected at the beginning of recovery （0 h）, 8 h and 24 h. Results： CO and PAWP levels decreased, but CI, CVP and SVR levels rose over time for both groups. In addition to CI in control group, CO, CI, CVP, PAWP and SVR all changed significantly for both group after 24h compared to Oh （all P value 〈0.05）. Re- peated measure ANOVA found that, SVR and CVP levels decreased, and PAWP levels increased compared with control group, and the difference statistically significant （all P value 〈0.05）. Conclusion： Using 6% 130/0.4 sodium chloride hydroxyethyl starch solution for pa- tients with septic shock to recover could better improve the patient＇s hemodynamic indices.