参附注射液治疗脓毒症休克的疗效分析

Effect of Shenfu injection on septic shock observed with the non-invasive cardiac output monitoring system

摘要:

目的 探讨应用无创心排量检测仪（NICOM）观察参附注射液治疗脓毒症休克效果。方法 选取2018年3月—2019年4月南京中医药大学南通附属医院院脓毒症休克重症患者23例行常规治疗，包括抗生素治疗、液体复苏、生命支持等，并在此基础上给予参附注射液治疗。观察患者治疗前后血流动力学参数［平均动脉压（MAP）、心功能指数（CI）、每搏变异指数（SVV）、外周总阻力指数（TPRI）］的变化情况，并比较治疗前后血乳酸水平的差异。结果 脓毒症休克患者给予参附注射液治疗，治疗前后MAP分别为78.0（68.5，85.5）mmHg、91.0（85.0，110.0）mmHg，治疗后水平升高（P <0.05）；治疗前后CI分别为3.20（2.65，3.60）L/（min·m²）、2.80（2.50，3.60）L/（min·m²），差异无统计学意义（P >0.05）；治疗前后SVV分别为0.17（0.12，0.19）、0.14（0.11，0.18），治疗后水平降低（P <0.05）；治疗前后TPRI分别为2 078.0（1 756.5，2 320.5）、2 732.0（2 186.0，3 274.5），治疗后水平升高 （P <0.05）；治疗前后血乳酸水平分别为2.60（2.00，3.35）mmol/L、1.70（1.10，2.20）mmol/L，治疗后水平下降（P <0.05）。结论 参附注射液对脓毒症休克患者血流动力学及血乳酸水平有较好的改善作用，对脓毒症休克有一定的治疗作用。

Abstract:

Objective To investigate the therapeutic effect of Shenfu injection on septic shock observed with the non-invasive cardiac output monitoring system (NICOM).Methods A total of 23 patients with septic shock were given with conventional therapy including antibiotic therapy, fluid infusion, and life support treatment and etc., and then were treated with Shenfu injection. Data of the non-invasive cardiac output measurement such as mean arterial pressure (MAP), cardiac index (CI), stroke volume variation (SVV), total peripheral resistance index (TPRI) were observed at 0 h and 12 h after treatment with Shenfu injection, and the level of lactic acid of blood (Lac) were observed at meantime.Results The level of MAP were 78.00 (68.50, 85.50) mmHg and 91.00 (85.00, 110.00) mmHg before and after treatment, and increased more significantly after therapy (P < 0.05); the CI were 3.20 (2.65, 3.60), 2.80 (2.50, 3.60) L/min/m² before and after treatment, and there were no difference (P > 0.05); the level of SVV were 0.17 (0.12, 0.19) and 0.14 (0.11, 0.18) before and after treatment, and decreased more significantly after therapy (P < 0.05); and the level of TPRI were 2 078.00 (1 756.50, 2 320.50), 2 732.00 (2 186.00, 3 274.50) sec/cm²/m² before and after treatment, and increased more significantly after treatment (P < 0.05). The level of lactic acid of blood were 2.60 (2.00, 3.35) and 1.70 (1.10, 2.20) mmol/L before and after treatment, and decreased more significantly after therapy (P < 0.05).Conclusion Shenfu injection can improve patient's state of hemodynamic in septic shock, and decrease the level of lactic acid of blood, with benefit for the treatment of patients with septic shock.