ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2017, Vol. 9 ›› Issue (3): 255-258.doi: 10.3969/j.issn.1674-3865.2017.03.023

• 临床研究 • 上一篇    下一篇

儿童感染性休克液体复苏疗法临床分析

陈小娟，冯惠蓝   

  1. 529400 广东 恩平，恩平市人民医院儿科
  • 出版日期:2017-06-25 发布日期:2017-12-08
  • 通讯作者: 冯惠蓝，E-mail：lanlan830816@163.com
  • 作者简介:陈小娟（1974-），女，副主任医师。研究方向：儿童重症医学及新生儿疾病的诊治

Clinical analysis of liquid resuscitation for septic shock in children

CHEN Xiaojuan，FENG Huilan   

  1. Enping People's Hospital, Enping 529400，China
  • Online:2017-06-25 Published:2017-12-08

PDF (PC)

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摘要：
目的
探讨液体复苏疗法对小儿感染性休克的治疗效果。
方法
2014年1月至2016年9月恩平市人民医院儿科收治住院的感染性休克患儿50例。随机分为液体复苏疗法组和传统扩容组各25例。入院后即进行生理盐水联合20%人血白蛋白复苏疗法和传统扩容疗法。比较两组初始1 h输入生理盐水量，初期复苏治疗目标(一期复苏成功率)，ICU住院治疗时间、pH值、Na+、Cl-水平，心率、中心静脉压、平均动脉压变化。
结果
液体复苏疗法组ICU住院时间低于传统扩容组，差异有统计学意义（P<0.01）。液体复苏疗法组初始1 h输入生理盐水量高于传统扩容组，差异有统计学意义（P<0.01）。两组患儿肺水肿发生率比较差异无统计学意义（P>0.05）。液体复苏疗法组死亡率为16.0%（4/25），低于传统扩容组48.0%（12/25），差异有统计学意义（P<0.05）。液体复苏疗法组一期复苏成功率为80.0%（20/25），高于传统扩容组52.0%（13/25），差异有统计学意义（P<0.05）。液体复苏疗法组患儿治疗后心率低于治疗前，平均动脉压、中心静脉压高于治疗前，差异有统计学意义（P<0.01）。液体复苏疗法组患儿复苏24 h pH值、Na+浓度高于治疗前，Cl- 浓度低于治疗前，差异有统计学意义（P<0.01）。
结论
生理盐水联合白蛋白对儿童感染性休克液体复苏效果明显，安全性好，值得推广。

关键词: 感染性休克, 生理盐水, 白蛋白, 液体复苏, 儿童

Abstract:
Objective
To study the therapeutic result of liquid resuscitation for children with septic shock.
Methods
A total of 50 children with septic shock were treated in Pediatric Department of Enping People's Hospital from Jan. 2014 to Sep. 2016, and they were randomly divided into two groups: liquid resuscitation group(A) and conventional dilatation group(B), 25 children in each group. After admission, the patients were given normal saline combined with 20% albumin resuscitation treatment and conventional dilatation treatment, respectively. Compare the first-hour infusion volume of normal saline, the primary resuscitation target(first-stage resuscitation success rate), length of ICU stay, pH value, level of Na+ and Cl-, heart rate and change of central venous pressure and average arterial pressure.
Results
The length of ICU stay of group A was shorter than that of group B, and the difference was statistical(P<0.01).The first-hour infusion volume of normal saline in group A was higher than that in group B, the difference being statistical(P<0.01). There was no statistical difference in the incidence rate of pulmonary edema between the two groups (P>0.05). The mortality of group A was 16.0%(4/25), lower than that of group B (48.0%,12/25), and there was statistical difference(P<0.05).The first-stage success rate of resuscitation of group A was 80.0%(20/25),higher than that of group B(52.0%,13/25),with statistical difference(P<0.05).The heart rate of children in group A after treatment was lower, and the average arterial pressure and central nervous pressure were higher than before treatment,and the difference was of statistical significance(P<0.01). The 24h pH value and Na+ concentration of children in group A were higher after treatment, while Cl- concentration was lower, the difference being statistical (P<0.01).
Conclusion
Liquid resuscitation with normal saline and albumin has significant effect on children with septic shock. It is safe and worth promoting.

Key words: Septic shock, Normal saline, Albumin, Liquid resuscitation, Child