本文選題：RASS評分　切入點：感染性休克　出處：《中華醫(yī)院感染學雜志》2016年19期 　論文類型：期刊論文

【摘要】：目的探討RASS評分對感染性休克患者改良早期目標導向治療(EGDT)的價值,以指導臨床治療。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,按照隨機數(shù)字表法分為試驗組和對照組,每組各46例,試驗組采用RASS評分指導鎮(zhèn)靜+改良EGDT,對照組采用常規(guī)鎮(zhèn)靜+EGDT,觀察28d,比較兩組患者機械通氣時間、住ICU時間、總費用、病死率和多器官功能障礙綜合征(MODS)發(fā)生率,并觀察兩組患者6、24h輸液量,測定治療前后肝功能、腎功能指標變化。結(jié)果試驗組患者機械通氣時間、入住ICU時間和住院總費用,均明顯低于對照組患者,差異有統(tǒng)計學意義(P0.05);試驗組患者28d病死率和MODS發(fā)生率分別為15.2%和34.8%,顯著低于對照組患者41.3%和60.9%,差異有統(tǒng)計學意義(P0.05);試驗組患者6、24h輸液總量顯著高于對照組;兩組患者治療前后肝功能和腎功能指標呈現(xiàn)先升高后下降趨勢,在治療后24h達到最大值。結(jié)論 RASS評分對感染性休克患者EGDT具有很大的指導價值,能縮短患者機械通氣時間,減少病死率,改善患者預后。
[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)學科;
【基金】：山東省衛(wèi)生廳基金資助項目(SW-2012B029)
【分類號】：R459.7

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