羟乙基淀粉注射液在脓毒性休克早期容量复苏中的应用价值研究

目的:评估羟乙基淀粉注射液在脓毒性休克早期容量复苏中的应用价值.方法:回顾性分析我院2005年1月至2010年12月收住院的43例脓毒性休克患者的临床资料;根据确诊脓毒性休克后是否应用羟乙基淀粉注射液(HES)进行液体复苏分为HES组和对照组,记录、检测复苏前后血流动力学指标的变化,比较两组血流动力学指标复苏前后的改善情况.结果:两组间性别、年龄、入组时的APACHEⅡ评分等一般指标均无统计学差异(P＞0.05);对照组与HES组容量复苏后血流动力学指标均有所好转;然而HES组改善幅度明显优于对照组,差异有统计学意义(P＜0.05),其中平均动脉压升高幅度及6小时乳酸清除率差异尤其显著(P＜0.01).结论:在脓毒性休克早期应用羟乙基淀粉(HES)进行容量复苏在改善血流动力学方面要优于单纯应用晶体液.

Effects of Hydroxyethyl Starch on the Early Volume Resuscitation of Septic Shock

Objective：To evaluate the effects of hydroxyethyl starch on the early volume resuscitation of septic shock. Methods： 43 patients with septic shock admitted in our hospital from Jan 2005 to Dec 2010 were involved and divided into two groups： the HES group and the control group. The hemodynamics indexes were recorded and detected before and after resuscitation.Their changes of hemodynamies indexes were compared. Results：There were no ignificant differences between the two groups on the following items such as age, sex and APACHE Ⅱ （P〉0.05）. The hemodynamics indexes of both of the two groups were improved. However, the improvement of the HES group was better than the control group and the differences had statistical significance （P〈0.05）, especially in mean arterial blood pressure and lactate clearance（P〈0.01）. Conclusion： In the early volume resuscitation of septic shock, the effects of HES on hemodynamies are better than crystal solution.