中华危重病急救医学
中華危重病急救醫學
중화위중병급구의학
Chinese Critical Care Medicine
2013年
4期
207-210
,共4页
王晓冬%霍习敏%徐梅先%耿文锦%郭艳梅%曹利静%孙慧%石晓娜%李君娥
王曉鼕%霍習敏%徐梅先%耿文錦%郭豔梅%曹利靜%孫慧%石曉娜%李君娥
왕효동%곽습민%서매선%경문금%곽염매%조리정%손혜%석효나%리군아
脓毒性休克%集束化治疗%乳酸%C-反应蛋白%降钙素原
膿毒性休剋%集束化治療%乳痠%C-反應蛋白%降鈣素原
농독성휴극%집속화치료%유산%C-반응단백%강개소원
Septic Shock%Bundle treatment%Lactic acid%C-reactive protein%Procalcitonin
目的 观察儿童脓毒性休克早期抗感染治疗的临床价值.方法 回顾性分析重症医学科收治的80例脓毒性休克患儿的集束化治疗,按照第1次抗菌药物使用时间将患儿分为两组,于入院后1h内开始抗感染治疗者作为观察组,入院后1 ～6h抗感染治疗者作为对照组,每组40例.对比两组患儿入院时、入院后24h及72h血乳酸、C-反应蛋白(CRP)、降钙素原(PCT)等水平.结果 观察组入院后24 h乳酸明显低于对照组(mmol/L:8.65±2.84比11.75±3.20,P＜0.01),入院后24 h和72 h CRP明显低于对照组(mg/L:66.25±8.55比91.77±7.71,22.03±7.46比50.11±7.30,均P＜0.01),入院后72 h PCT明显低于对照组(μg/L:0.67±0.31比1.16±0.25,P＜0.01).观察组休克持续时间较对照组明显缩短(h:6.80±3.70比12.80±3.63,P＜0.05),但病死率差异无统计学意义[5％(2/40)比10％(4/40),P＞0.05].结论 给予脓毒性休克患儿早期经验性抗感染治疗可以缩短休克持续时间,更早发挥抗炎抗休克的作用,从而提升脓毒性休克抢救成功率.
目的 觀察兒童膿毒性休剋早期抗感染治療的臨床價值.方法 迴顧性分析重癥醫學科收治的80例膿毒性休剋患兒的集束化治療,按照第1次抗菌藥物使用時間將患兒分為兩組,于入院後1h內開始抗感染治療者作為觀察組,入院後1 ～6h抗感染治療者作為對照組,每組40例.對比兩組患兒入院時、入院後24h及72h血乳痠、C-反應蛋白(CRP)、降鈣素原(PCT)等水平.結果 觀察組入院後24 h乳痠明顯低于對照組(mmol/L:8.65±2.84比11.75±3.20,P＜0.01),入院後24 h和72 h CRP明顯低于對照組(mg/L:66.25±8.55比91.77±7.71,22.03±7.46比50.11±7.30,均P＜0.01),入院後72 h PCT明顯低于對照組(μg/L:0.67±0.31比1.16±0.25,P＜0.01).觀察組休剋持續時間較對照組明顯縮短(h:6.80±3.70比12.80±3.63,P＜0.05),但病死率差異無統計學意義[5％(2/40)比10％(4/40),P＞0.05].結論 給予膿毒性休剋患兒早期經驗性抗感染治療可以縮短休剋持續時間,更早髮揮抗炎抗休剋的作用,從而提升膿毒性休剋搶救成功率.
목적 관찰인동농독성휴극조기항감염치료적림상개치.방법 회고성분석중증의학과수치적80례농독성휴극환인적집속화치료,안조제1차항균약물사용시간장환인분위량조,우입원후1h내개시항감염치료자작위관찰조,입원후1 ～6h항감염치료자작위대조조,매조40례.대비량조환인입원시、입원후24h급72h혈유산、C-반응단백(CRP)、강개소원(PCT)등수평.결과 관찰조입원후24 h유산명현저우대조조(mmol/L:8.65±2.84비11.75±3.20,P＜0.01),입원후24 h화72 h CRP명현저우대조조(mg/L:66.25±8.55비91.77±7.71,22.03±7.46비50.11±7.30,균P＜0.01),입원후72 h PCT명현저우대조조(μg/L:0.67±0.31비1.16±0.25,P＜0.01).관찰조휴극지속시간교대조조명현축단(h:6.80±3.70비12.80±3.63,P＜0.05),단병사솔차이무통계학의의[5％(2/40)비10％(4/40),P＞0.05].결론 급여농독성휴극환인조기경험성항감염치료가이축단휴극지속시간,경조발휘항염항휴극적작용,종이제승농독성휴극창구성공솔.
Objective To investigate the value of timing of antibiotics in pediatric septic shock.Methods Eighty children with septic shock treated with bundle treatment in Department of Critical Care Medicine were retrospectively analyzed.Eighty children with septic shock were divided into observation group (n =40,anti-infection therapy within 1 hour after admission) and control group (n=40,anti-infection therapy 1-6 hours after admission).The contents of lactate,C-reaction protein (CRP) and procalcitonin (PCT) were compared between two groups at admission and 24 hours and 72 hours after admission.Results Lactate in the observation group was significantly lower than that of the control group within the first 24 hours after admission (mmol/L:8.65 ± 2.84 vs.11.75 ± 3.20,P＜0.01).CRP in the observation group was significantly lower than that of the control group 24 hours and 72 hours after admission (mg/L:66.25 ±8.55 vs.91.77 ±7.71,22.03 ±7.46 vs.50.11 ±7.30,both P＜0.01).PCT in the observation group was significantly lower than that of the control group 72 hours after admission (μg/L:0.67 ± 0.31 vs.1.16 ±.0.25,P＜0.01).Time for shock recovery in the observation group was significantly shorter than that of the control group (hours:6.80 ±3.70 vs.12.80 ± 3.63,P＜0.05),but no statistical difference in mortality rate between groups was found [5％ (2/40) vs.10％ (4/40),P＞0.05].Conclusion With the early empirical anti-infection treatment in pediatric septic shocked patients,time for recovery from shock can be shortened and successful rate of resuscitation can be improved.
