Xie Rong-fang
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2016 Mar;36(3):306-9.
To explore the effect of early goal-directed therapy (EGDT) combined with Yiqi Fumai Lyophilized Powder (YFLP) on central venous-arterial carbon dioxide difference [P(cv-a)CO2] and central venous oxygen saturation (S(cv)O2) in patients with septic shock.
Totally 50 patients with septic shock were assigned to the control group and the treatment group according to random digit table, 25 cases in each group. Patients in the control group received treatment according to EGDT principle. Those in the treatment group were intravenously injected with YFLP (5.2 g adding in 500 mL normal saline) additionally. Changes of P(cv-a)CO2, S(cv)O2, lactic acid, central venous pressure (CVP), mean arterial pressure (MAP), and APACHE II score were observed in the two groups before and after treatment. The 6-h success rate and 28-day mortality were also observed.
Compared with before treatment in the same group, lactic acid and APACHE II score decreased, levels of S(cv)O2, MAP, CVP increased in the two groups after treatment (P < 0.01). P(cv-a)CO2 decreased more obviously after treatment in the treatment group, and lower than that in the control group after treatment (P < 0. 05, P < 0. 01). The 6-h success rate was 48% (12/25) in the control group and 76% (19/25) in the treatment group (P < 0.05). The 28-day mortality was 36% (9/25) in the control group and 12% (3/25) in the treatment group (P < 0.05).
EGDT combined with YFLP could significantly elevate S(cv)O2, decrease P(cv-a)CO2 and mortality in patients with septic shock, and obviously improve the clinical effect.
探讨早期目标导向治疗（EGDT）联合益气复脉冻干粉（YFLP）对感染性休克患者中心静脉 - 动脉血二氧化碳分压差[P（cv - a）CO2]及中心静脉血氧饱和度（S（cv）O2）的影响。
将50例感染性休克患者按随机数字表法分为对照组和治疗组，每组25例。对照组按EGDT原则进行治疗，治疗组在此基础上额外静脉滴注YFLP（5.2 g加入500 mL生理盐水中）。观察两组治疗前后P（cv - a）CO2、S（cv）O2、乳酸、中心静脉压（CVP）、平均动脉压（MAP）及急性生理与慢性健康状况评分系统II（APACHE II）评分的变化。同时观察两组6小时成功率及28天死亡率。
与同组治疗前比较，两组治疗后乳酸及APACHE II评分降低，S（cv）O2、MAP、CVP水平升高（P < 0.01）。治疗组治疗后P（cv - a）CO2下降更明显，且低于对照组治疗后（P < 0.05，P < 0.01）。对照组6小时成功率为48%（12/25），治疗组为76%（19/25）（P < 0.05）。对照组28天死亡率为36%（9/25），治疗组为12%（3/25）（P < 0.05）。
EGDT联合YFLP可显著提高感染性休克患者的S（cv）O2，降低P（cv - a）CO2及死亡率，明显改善临床疗效。
