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硝酸甘油对脓毒性休克患者复苏达标后微循环的影响
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硝酸甘油对脓毒性休克患者复苏达标后微循环的影响
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Journal Article
硝酸甘油对脓毒性休克患者复苏达标后微循环的影响
2016
Overview
目的评价硝酸甘油对脓毒性休克患者复苏达标后微循环及病死率的影响。方法选取2014年1月-2015年1月兰州大学第一医院重症医学科收治的符合脓毒性休克标准的患者,休克复苏达标后随机分为对照组和硝酸甘油组。对照组给予标准治疗,硝酸甘油组在标准治疗基础上,给予硝酸甘油0.5-1.0mg/h静脉泵入。入组后监测两组患者治疗后0、6、24、72h时的舌下微循环指标,包括小血管总密度（TVDs）、灌注小血管密度（PVDs）、灌注小血管比例（PPVs）、微血管流量指数（MFI）、异质性指数。记录患者ICU住院时间、总住院时间及随访28d病死率。结果入组53例患者,其中对照组26例,硝酸甘油组27例。治疗24、72h两组患者TVDs均未明显增加,而PVDs、PPVs、MFI、异质性指数在治疗6、24、72h时较入组时提高,治疗24、72h较6h明显升高。硝酸甘油组治疗72h各微循环指标明显高于对照组（P〈0.05）,机械通气时间明显低于对照组（P〈0.05）,ICU住院时间及总住院时间明显短于对照组（P〈0.05）,住院病死率及28d病死率均低于对照组（P〈0.05）。结论硝酸甘油对感染性休克复苏达标后患者微循环有显著改善作用,并可有效改善患者预后,降低机械通气时间、ICU停留时间、总住院时间以及病死率。
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