[1]徐 玫.早期目标导向治疗老年脓毒性休克的抢救效果及疗效影响因素分析[J].陕西医学杂志,2019,(4):488-491.
　XU Mei..Effect of early goaloriented treatment on septic shock in elderly patients and its influencing factors[J].,2019,(4):488-491.
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早期目标导向治疗老年脓毒性休克的抢救效果及疗效影响因素分析
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年4期
页码:
488-491
栏目:
临床研究
出版日期:
2019-04-05

文章信息/Info

Title:
Effect of early goaloriented treatment on septic shock in elderly patients and its influencing factors
文章编号:
DOI: 10.3969/j.issn.10007377.2019.04.023
作者:
徐 玫
四川省彭州市中医医院重症医学科（彭州611930）
Author(s):
XU Mei.
Pengzhou Hospital of Traditional Chinese Medicine in Sichuan Province（Pengzhou 611930）
关键词:
目标导向治疗; 老年; 脓毒性休克; 抢救效果; 疗效; 影响因素
Keywords:
Key words EGDT;  Elderly;  Septic shock;  Rescue effect; Eefficacy;  Influencing factors
分类号:
R631+4
文献标志码:
A
摘要:
摘 要 目的：研究早期目标导向治疗(EGDT)老年脓毒性休克的抢救效果及疗效影响因素分析。方法：选取老年脓毒性休克患者88例，采用随机数字法将其分为对照组和观察组，每组各44例。对照组患者采用传统抗休克治疗，观察组患者接受EGDT治疗。比较两组患者的治疗后第6 h尿量、ICU住院时间及28 d病死率，同时比较治疗前后的中心静脉压(CVP)、平均动脉压(MAP)、器官衰竭(ScvO2)、血氧饱和度(SOFA)及APACHE II评分。并根据复苏6 h后复苏效果分为达标组和未达标组，分别为31例和13例，分析影响达标的影响因素。结果：观察组的治疗后第6 h尿量明显高于对照组(P<0.05)，ICU住院时间和28 d病死率明显低于对照组(P<0.05)；治疗后24 h，观察组的CVP、MAP及ScvO2均明显高于对照组(P<0.05)，两组患者的SOFA和APACHE II评分比较无明显差异(P>0.05)；达标组的年龄、复苏前APACHE II评分及28 d病死率均明显低于未达标组(P<0.05)，复苏前MAP明显高于未达标组(P<0.05)。结论：严格按照 EGDT 方案（包含静脉抗生素治疗、足够的体液复苏及血液动力学支持）并不能改善老年脓毒血症性休克患者的预后。
Abstract:
Abstract Objective:To study the effect of early goaloriented therapy (EGDT) on septic shock in elderly patients and its influencing factors. Methods: 88 cases older septic shock patients were divided into control group and observation group by random number method, 44 cases in each group. Patients in the control group received traditional antishock treatment, and the observation group received EGDT treatment.Compared two groups of the urine levels, ICU hospital stay and 28day mortality, and compared before and after treatment of the CVP, MAP, ScvO2, SOFA and APACHE II scores. And the resuscitation effect was divided into the standard group and the noncompliance group, which were 31 cases and 13 cases respectively.Analysis the influencing factors.Results:The urine output of the observation group was significantly higher than the control group (P<0.05). The ICU hospital stay and the mortality rate at 28 days were significantly lower than the control group (P<0.05) And ScvO2 were significantly higher than those in the control group (P<0.05). There was no significant difference in SOFA and APACHE II scores between the two groups (P>0.05).The standard group of the APACHE II score and the 28d mortality were significantly lower than the untreated group (P<0.05), and the MAP before resuscitation was significantly higher than the untreated group(P<0.05).Conclusion:In strict accordance with the EGDT regimen (including intravenous antibiotic therapy, fluid resuscitation and hemodynamic enough support) did not improve the prognosis of elderly patients with septic shock.

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更新日期/Last Update: 2019-04-10