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目的:研究休克指数(SI)对感染性休克患者预后的预测作用。方法:研究选入98例诊断为严重感染或感染性休克的患者,记录早期复苏开始时、复苏6h后的情况及6h后的休克指数。然后根据复苏6h后的情况分为A、B、C、D四组。A组为实现EGDT同时SI≤0.7,B组为实现EGDT但SI>0.7,C组未能实现EGDT但SI≤0.7,D组未能实现EGDT同时SI>0.7。比较四组之间6h乳酸清除率及预后。结果:6h乳酸清除率A组与其他3组均有差异,B、C两组间无差异,D与其他3组均有差异。A组的28d病死率低于D组,其余组间无差异。实现EDGT目标患者6h乳酸清除率及28d病死率均优于未实现EGDT目标者。SI≤0.7组患者6h乳酸清除率及28d病死率均优于SI>0.7组患者。结论:感染性休克患者在早期复苏后,实现EGDT组预后优于未实现EGDT组,SI≤0.7组预后优于SI>0.7组。如能同时实现EGDT目标和SI≤0.7,则预后显著优于其他组。SI能作为经早期复苏后感染性休克患者预测预后的指标。
Objective: To study the predictive effect of shock index (SI) on the prognosis of septic shock patients. Methods: A total of 98 patients diagnosed as having severe infection or septic shock were enrolled in this study. The condition of 6 h after resuscitation and the shock index after 6 h were recorded. Then according to the situation after the recovery 6h is divided into A, B, C, D four groups. In group A, SI≤0.7 for EGDT, SI> 0.7 for EGDT in group B, SI≤0.7 for failed EGDT in group C, and> 0.7 for D group. The lactic acid clearance and prognosis were compared between the four groups. Results: The lactic acid clearance rate of group A was different from that of the other three groups at 6h, there was no difference between groups B and C, and D was different from the other three groups. The 28-day mortality in group A was lower than that in group D, and there was no difference in other groups. Patients achieving EDGT had a 6-h lactic acid clearance and a 28-day mortality rate better than those who did not achieve EGDT. The lactic acid clearance rate at 6h and the mortality rate at 28d in SI≤0.7 group were better than those in SI> 0.7 group. Conclusion: After the early resuscitation in septic shock patients, the prognosis of EGDT group is better than that of non-EGDT group. The prognosis of SI≤0.7 group is better than that of SI> 0.7 group. If both EGDT goals and SI ≤ 0.7, the prognosis was significantly better than the other groups. SI can be used as an indicator of prognosis in septic shock patients after early resuscitation.