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目的探讨低血容量性休克患者在脉搏灌注指数变异(Pleth Viability Index,PVI)指导下液体复苏对预后的影响。方法分析河北省人民医院重症医学科近年救治的低血容量性休克病例40例,分成PVI指导下液体复苏组和常规液体复苏组,分别测定发生低血容量性休克后2、6、12、24h时血浆TNF-α、IL-6、血乳酸及MODS发生率及病死率。结果采用PVI指导下液体复苏和常规液体复苏方法治疗低血容量性休克患者血浆TNF-α、IL-6、血乳酸比较差异有统计学意义(P<0.05),但MODS发生率及病死率差异无统计学意义。结论 PVI指导下液体复苏能较快改善低血容量性休克患者微循环状态,减轻炎症反应状态,但MODS发生率及病死率影响不大,需要大样本进一步研究证实。
Objective To investigate the effect of fluid resuscitation on the prognosis of patients with hypovolemic shock under the guidance of Pleth Viability Index (PVI). Methods Forty patients with hypovolemic shock who were treated in Department of Critical Care Medicine of Hebei Provincial People’s Hospital in recent years were divided into liquid resuscitation group under PVI and conventional liquid resuscitation group, and were respectively measured at 2,6,12,24 h after hypovolemic shock When the plasma TNF-α, IL-6, blood lactate and MODS incidence and mortality. Results The plasma levels of TNF-α, IL-6 and blood lactate in patients with hypovolemic shock treated with PVI under the guidance of liquid resuscitation and conventional liquid resuscitation were significantly different (P <0.05), but the incidence of MODS and mortality were different No statistical significance. Conclusion Liquid resuscitation under the guidance of PVI can improve the microcirculation state and reduce the inflammatory response in patients with hypovolemic shock. However, the incidence of MODS and the mortality rate are not significant, and large samples need further study to confirm.