本文選題：RASS評(píng)分　切入點(diǎn)：感染性休克　出處：《中華醫(yī)院感染學(xué)雜志》2016年19期 　論文類(lèi)型：期刊論文

【摘要】：目的探討RASS評(píng)分對(duì)感染性休克患者改良早期目標(biāo)導(dǎo)向治療(EGDT)的價(jià)值,以指導(dǎo)臨床治療。方法選取2013年10月-2015年6月醫(yī)院ICU收治的感染性休克患者92例,按照隨機(jī)數(shù)字表法分為試驗(yàn)組和對(duì)照組,每組各46例,試驗(yàn)組采用RASS評(píng)分指導(dǎo)鎮(zhèn)靜+改良EGDT,對(duì)照組采用常規(guī)鎮(zhèn)靜+EGDT,觀(guān)察28d,比較兩組患者機(jī)械通氣時(shí)間、住ICU時(shí)間、總費(fèi)用、病死率和多器官功能障礙綜合征(MODS)發(fā)生率,并觀(guān)察兩組患者6、24h輸液量,測(cè)定治療前后肝功能、腎功能指標(biāo)變化。結(jié)果試驗(yàn)組患者機(jī)械通氣時(shí)間、入住ICU時(shí)間和住院總費(fèi)用,均明顯低于對(duì)照組患者,差異有統(tǒng)計(jì)學(xué)意義(P0.05);試驗(yàn)組患者28d病死率和MODS發(fā)生率分別為15.2%和34.8%,顯著低于對(duì)照組患者41.3%和60.9%,差異有統(tǒng)計(jì)學(xué)意義(P0.05);試驗(yàn)組患者6、24h輸液總量顯著高于對(duì)照組;兩組患者治療前后肝功能和腎功能指標(biāo)呈現(xiàn)先升高后下降趨勢(shì),在治療后24h達(dá)到最大值。結(jié)論 RASS評(píng)分對(duì)感染性休克患者EGDT具有很大的指導(dǎo)價(jià)值,能縮短患者機(jī)械通氣時(shí)間,減少病死率,改善患者預(yù)后。
[Abstract]:Objective to evaluate the value of RASS score in the treatment of septic shock patients with modified early goal-oriented therapy. Methods 92 patients with septic shock admitted to ICU from October 2013 to June 2015 were selected. According to the random digital table method, the patients were divided into the experimental group and the control group with 46 cases in each group. The experimental group used RASS score to guide the sedation improved EGDT.The control group was treated with routine sedation and observed for 28 days. The duration of mechanical ventilation, residence time of ICU, total cost were compared between the two groups. The mortality rate and the incidence of multiple organ dysfunction syndrome (MODS) were observed. The volume of infusion at 6h and the changes of liver function and renal function before and after treatment were observed. Results the time of mechanical ventilation, the time to stay in ICU and the total cost of hospitalization were measured in the experimental group. All of them were significantly lower than those in the control group. The fatality rate and MODS incidence in the trial group were 15.2% and 34.8, respectively, which were significantly lower than those in the control group (41.3% and 60.9, P 0.05), and the total infusion volume in the test group was significantly higher than that in the control group. Before and after treatment, the indexes of liver function and renal function in both groups increased first and then decreased, and reached the maximum at 24 hours after treatment. Conclusion RASS score has great guiding value for EGDT in patients with septic shock and can shorten the time of mechanical ventilation in patients with septic shock. Reduce the mortality and improve the prognosis of patients.
【作者單位】： 威海市立醫(yī)院重癥醫(yī)學(xué)科;
【基金】：山東省衛(wèi)生廳基金資助項(xiàng)目(SW-2012B029)
【分類(lèi)號(hào)】：R459.7

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