目的 探討早期堿剩余對感染性休克患者病情嚴重程度的預測價值。 方法 對2009年2月－2011年2月資料完整入院的感染性休克患者60例進行回顧性分析，按死亡及存活進行分組，對最初24 h的堿剩余值差異及血乳酸清除率情況進行對照研究。 結果 死亡組堿剩余值變化及乳酸清除率低于存活組（P＜0.05）。治療后堿剩余≤?6 mmol/L較堿剩余＞?6 mmol/L的患者病死率明顯增加，尤其是治療后24 h 堿剩余仍≤?6 mmol/L病死率高達92.23%。 結論 早期堿剩余有助于感染性休克預后評估和指導臨床治療。
【摘要】 目的 探討膿毒性休克早期液體復蘇的臨床反應性。 方法 對2008年2月—2010年2月38例采用早期目標定向治療方案治療的膿毒性休克患者按是否存活進行分組，就中心靜脈壓、心率、平均動脈壓、輸液量、尿量、血乳酸等指標進行評價。 結果 38例采用早期目標定向治療方案治療6 h均達標，存活21例（55.26%），死亡17例（44.74%），兩組患者輸液總量及輸液種類差異無統計學意義（Pgt;0.05），存活組6、24 h尿量及血乳酸清除率明顯優于死亡組（Plt;0.05）。 結論 血乳酸清除率及尿量可作為膿毒性休克液體復蘇有效的臨床監測指標。【Abstract】 Objective To study the clinical response to early fluid resuscitation therapy in septic shock patients. Methods Thirty-eight septic shock patients received early goal-directed therapy (EGDT) in the ICU of our hospital from February 2008 to February 2010. The patients were divided into survival group (n=21) and dead group (n=17). Indexes like central venous pressure (CVP), heart rate (HR), mean arterial pressure (MAP), fluid input, urine output, and blood lactate were evaluated. Results Six hours after the EGDT, the results for the patients were all up to standard. There were 21 cases of survival (55.26%) and 17 cases of death (44.74%). The total fluid input and liquid types were similar in the two groups (Pgt;0.05). The urine output and lactate clearance at hour 6 and 24 for the survival group were better than that for the dead group (Plt;0.05). Conclusion The lactate clearance and urine output can be regarded as an surveillance indicator of fluid resuscitation for patients with septic shock.