CAJ | 학술논문

目的探讨严重感染集束治疗(SBT)策略在严重烧伤患者早期治疗中的实施情况及作用.方法 95例重症烧伤患者,按治疗方式分为对照组43例和观察组52例.记录严重感染、感染性休克发生率、28 d病死率和6 h、24 h集束治疗的依从率,logistic回归分析6 h、24 h集束治疗指标与感染、感染性休克发生及28 d病死率的关系.结果观察组28天病死率、脓毒血症和感染性休克的发生率均明显低于对照组(P<0.05).早期目标导向液体治疗(EGDT)是烧伤感染和感染性休克发生的独立相关因素.血气分析测定、EGDT及血管活性药物的使用与28天病死率密切相关(P<0.05).烧伤感染、感染性休克的发生和28天病死率均与SBT方案的执行情况密切相关.观察组感染集束治疗指标的依从性仅为51.9%和63.2%.结论 SBT方案能减少烧伤感染和感染性休克的发生,降低病死率,但依从性尚亟待提高.
목적 탐토엄중감염집속치료(SBT)책략재엄중소상환자조기치료중적실시정황급작용.방법 95례중증소상환자,안치료방식분위대조조43례화관찰조52례.기록엄중감염、감염성휴극발생솔、28 d병사솔화6 h、24 h집속치료적의종솔,logistic회귀분석6 h、24 h집속치료지표여감염、감염성휴극발생급28 d병사솔적관계.결과 관찰조28천병사솔、농독혈증화감염성휴극적발생솔균명현저우대조조(P<0.05).조기목표도향액체치료(EGDT)시소상감염화감염성휴극발생적독립상관인소.혈기분석측정、EGDT급혈관활성약물적사용여28천병사솔밀절상관(P<0.05).소상감염、감염성휴극적발생화28천병사솔균여SBT방안적집행정황밀절상관.관찰조감염집속치료지표적의종성부위51.9%화63.2%.결론 SBT방안능감소소상감염화감염성휴극적발생,강저병사솔,단의종성상극대제고.
Objective To evaluate the impact of sepsis bundle treatment on morbidity of sepsis or septic shock in burned patients. Methods A retrospective clinical study was conducted on burned patients with severe sepsis or sepsis shock in burn intensive care unit. 95 patients were divided into control group(43 patients) and study group (52 patients)according to their treatment. The relationship between sepsis bundle index and sepsis, septic shock and 28-day mortality respectively were analyzed with logistic regression analysis. The compliance of sepsis bundles,and 28-day mortality were noted. Results The 28-day mortility rate,the mobidity of sepsis and septic shock in study group was lower than that of control group (P ＜ 0. 05). It could be found that 6-hour EGDT and 24-hour EGDT was the independent protective factor of sepsis and septic shock through logistic regression analysis ,and blood gas analysis, EGDT and vasoactive drug were correlated with 28-day mortality(P ＜0. 05). Compliance with sepsis bundles of 6-hour EGDT and 24-hour EGDT in study group was only 51.9%, and 63.2% respectively. Conclusion Sepsis bundle was able to improve survival rate in severe burn patients. Compliance with sepsis bundles in burn medical staff needed a buring improve.