本文關(guān)鍵詞： 參麥注射液 胰島素 膿毒癥 應(yīng)激性高血糖 死亡率 急性生理與慢性健康評分　出處：《中國藥房》2016年24期 　論文類型：期刊論文

【摘要】：目的:觀察參麥注射液聯(lián)合胰島素強(qiáng)化治療膿毒癥患者應(yīng)激性高血糖的療效。方法:回顧性收集156例膿毒癥且確診為應(yīng)激性高血糖患者資料,按用藥不同分為對照組(78例)和觀察組(78例)。所有患者及時(shí)確定病原菌并給予相應(yīng)的抗感染治療、改善通氣狀態(tài)、給予充分液體復(fù)蘇支持、適當(dāng)給予免疫治療和營養(yǎng)支持等常規(guī)治療;在此基礎(chǔ)上,對照組患者按不同的血糖水平給予不同劑量的胰島素[1 U/ml,靜脈微量泵入,速度為0.1 U/(kg·h)];觀察組患者在對照組治療的基礎(chǔ)上加用參脈注射液40 ml,加入胰島素混合溶液中,靜脈微量泵入。觀察兩組患者終點(diǎn)事件、血糖達(dá)標(biāo)時(shí)間、胰島素總用量、基礎(chǔ)指標(biāo)[急性生理與慢性健康(24APACHE-Ⅱ)評分、機(jī)械通氣時(shí)間、ICU住院天數(shù)、低血糖發(fā)生例次]及不良反應(yīng)發(fā)生情況。結(jié)果:觀察組患者終點(diǎn)事件總發(fā)生率顯著低于對照組,血糖達(dá)標(biāo)時(shí)間顯著短于對照組,胰島素總用量顯著少于對照組,機(jī)械通氣時(shí)間顯著短于對照組,ICU住院時(shí)間顯著少于對照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);治療前,兩組患者24 APACHE-Ⅱ評分差異無統(tǒng)計(jì)學(xué)意義(P0.05);治療后,兩組患者24 APACHE-Ⅱ評分顯著降低,且觀察組低于對照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者治療期間均未見明顯不良反應(yīng)發(fā)生。結(jié)論:在常規(guī)治療的基礎(chǔ)上,參麥注射液聯(lián)合胰島素強(qiáng)化治療膿毒癥患者應(yīng)激性高血糖療效較好,能減少達(dá)標(biāo)血糖所用時(shí)間胰島素總用量,降低終點(diǎn)事件總發(fā)生率和24 APACHE-Ⅱ評分,縮短機(jī)械通氣時(shí)間、減少ICU住院天數(shù),且安全性較好。
[Abstract]:Objective: to observe the effect of Shenmai injection combined with insulin intensive therapy on stress hyperglycemia in sepsis. Methods: 156 patients with sepsis and diagnosed as stress hyperglycemia were collected retrospectively. The patients were divided into control group (n = 78) and observation group (n = 78) according to their medication. All the patients were given appropriate anti-infective therapy, improved ventilation and adequate fluid resuscitation support. The patients in the control group were given different doses of insulin according to different levels of blood glucose [1 U / ml, intravenous micropump,] on the basis of appropriate routine therapy such as immunotherapy and nutritional support. The patients in the observation group were treated with Shenmai injection 40 ml on the basis of the treatment in the control group. The patients in the observation group were injected with insulin mixed solution and pumped into the vein microinjection. The endpoint events, the time of blood glucose reaching the standard, and the total amount of insulin were observed in the two groups. Basic index [acute physiology and chronic health 24APACHE- 鈪，

本文編號：1540268