【摘要】：目的探討氫化可的松琥珀酸鈉靜脈滴注與微量泵注給藥對(duì)重癥膿毒血癥繼發(fā)休克患者生命體征、動(dòng)態(tài)血糖指標(biāo)及死亡率的影響。方法選取該院2014年6月-2016年6月收治重癥膿毒血癥繼發(fā)休克患者共100例。采用隨機(jī)數(shù)字表法分為A組(50例)和B組(50例),在常規(guī)對(duì)癥干預(yù)基礎(chǔ)上分別給予氫化可的松琥珀酸鈉靜脈滴注與微量泵注給藥。比較兩組患者休克持續(xù)時(shí)間、ICU住院時(shí)間、總住院時(shí)間、28 d死亡率、治療前后生命體征指標(biāo)、治療后血乳酸清除率和動(dòng)態(tài)血糖監(jiān)測(cè)指標(biāo)水平。結(jié)果兩組患者休克持續(xù)時(shí)間,ICU住院時(shí)間及總住院時(shí)間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者28 d內(nèi)死亡率比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者治療前后HR、MAP及CVP水平組間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者治療后6、24及48 h血乳酸清除率比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者平均血糖值(MBG)水平比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);但B組患者最大血糖波動(dòng)幅度(LAGE)、血糖波動(dòng)系數(shù)(GV)及高血糖時(shí)間窗水平均低于A組(P0.05)。結(jié)論氫化可的松琥珀酸鈉2種給藥方式治療重癥膿毒血癥繼發(fā)休克臨床療效相當(dāng),但微量泵注給藥方式應(yīng)用可有效提高血糖穩(wěn)定性,維持機(jī)體代謝平衡。
[Abstract]:Objective to investigate the effects of intravenous infusion of hydrocortisone sodium succinate and micropump on vital signs, dynamic blood glucose and mortality in patients with severe sepsis secondary shock. Methods 100 patients with severe sepsis secondary shock were selected from June 2014 to June 2016. Patients in group A (n = 50) and group B (n = 50) were randomly divided into two groups: group A (n = 50) and group B (n = 50). On the basis of routine intervention, hydrocortisone sodium succinate was given intravenously and micropump respectively. The duration of shock in ICU, the mortality rate of 28 days, vital signs, the clearance rate of blood lactic acid and the level of dynamic blood glucose were compared between the two groups. Results there was no significant difference in duration of shock and duration of ICU and total hospitalization time between the two groups (P0.05), there was no significant difference in mortality rate within 28 days between the two groups (P0.05); HRMAP and CVP levels before and after treatment were not significantly different between the two groups (P0.05). There was no significant difference between the two groups (P0.05); there was no significant difference in the clearance rate of lactate between the two groups at 6h and 48h after treatment (P0.05); there was no significant difference in the mean blood glucose (MBG) level between the two groups (P0.05); but there was no significant difference between the two groups (P0.05), but the maximum blood glucose level in group B was not significant (P0.05). The fluctuation amplitude of sugar (age), the fluctuation coefficient of blood glucose (GV) and the level of hyperglycemia time window were lower than those in group A (P0.05). Conclusion the clinical efficacy of hydrocortisone sodium succinate in the treatment of severe sepsis secondary shock is similar, but the application of micropump injection can effectively improve the stability of blood glucose and maintain the metabolic balance of the body.
【作者單位】： 天津市天津醫(yī)院內(nèi)科ICU;
【分類號(hào)】：R459.7

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