参附注射液治疗脓毒症休克患者临床观察

摘要

目的 观察参附注射液对脓毒症休克患者的预后影响并探讨其机制.方法 选择我院ICU收治的71例脓毒症休克患者作为研究对象,随机分为两组,对照组给予常规治疗,治疗组在对照组治疗的基础上给予参附注射液治疗,比较两组患者入组时及24 h后血血乳酸(Lac)、中心静脉血氧饱合度(ScvO2)、24 h乳酸清除率,尿量、入组当日及48 h急性生理与慢性健康(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分,受损器官数目,入组后6h、12h、24 h、48 h多巴酚丁胺及去甲肾上腺素剂量,以及患者ICU平均住院日、28 d病死率.结果 治疗组Lac、ScvO2、尿量、24 h乳酸清除率指标均优于对照组(P<0.05);治疗组6h、12 h多巴酚丁胺剂量显著少于对照组(P<0.05).结论 在脓毒症休克24h集束化治疗结合参附注射液治疗可以改善患者的组织灌注水平,但对患者ICU平均住院日及28 d病死率预后影响改善不很明显.%Objective: To observe the effect of Shenfu Injection on prognosis of septic shock and explore its nechanism.Methods: 61 patients with septic shock in ICU were randomly divided into 2 groups.The control group was given conventional treatment,and the treatment group was treated with Shenfu Injection on the basis of the treatment of the control group.The following data was Compared between the two groups: Lac and ScvO2 at baseline and after 24 h,lactate clearance rate after 24 h,urine volume,APACHE Ⅱ and SOFA scores at baseline and after 48 h, number of damaged organs, Dobutamine and norepinephrine dose of 6 h, 12 h,24 h and 48 h after admission, the average hospitalization days and fatality rate after 28 d.Results: Lac, ScvO2, urine volume and 24h lactate clearance rate in treatment group were better than those in control group (P< 0.05).The dobutamine dose of 6 h and 12 h in the treatment group was significantly less than that in the control group (P<0.05).Conclusion: 24 hours after septic shock,cluster therapy combined with Shenfu Injection can improve the level of tissue perfusion, but the improvement of the prognosis of the average length of stay in ICU and 28 d mortality is not obvious.