CAJ | 학술논문

目的探讨集速化治疗感染性休克的临床效果分析.方法随机抽取2011年5月—2012年12月由新疆克州人民医院重症医学科收治的60例感染性体克患者的病例. 分别为对照组30例和观察组30例,对照组采用常规治疗,观察组采用集束化治疗,采用6h和24h感染性休克集速化治疗,对照两组的临床疗效.结果 ①在6h的集速化治疗中:观察组与对照组相比,观察组的患者在入重症科后,初步确诊的时间、抗生素治疗前获取血培养的实施率、血清乳酸测定率、2h内置入中心静脉导管、1 h内给予经验性抗生素治疗、应用血管活性药物、6 hEGDT 达标率差异具有统计学意义(P<0.05);②24 h内的管理集速化治疗中:观察组在血糖控制、小剂量的糖皮质激素使用率以及保护性肺通气策略上和对照组的比较差异具有统计学意义(P<0.05);③通过两组的临床比较,观察组的机械通气时间、入住ICU的时间比较差异无统计学意义(P>0.05).结论以6 h和24 h感染性休克集速化治疗为核心的临床途径,可以提高ICU 医师对SSC指南的操作,降低患者感染性休克的死亡率与感染率.
목적 탐토집속화치료감염성휴극적림상효과분석.방법 수궤추취2011년5월—2012년12월유신강극주인민의원중증의학과수치적60례감염성체극환자적병례. 분별위대조조30례화관찰조30례,대조조채용상규치료,관찰조채용집속화치료,채용6h화24h감염성휴극집속화치료,대조량조적림상료효.결과 ①재6h적집속화치료중:관찰조여대조조상비,관찰조적환자재입중증과후,초보학진적시간、항생소치료전획취혈배양적실시솔、혈청유산측정솔、2h내치입중심정맥도관、1 h내급여경험성항생소치료、응용혈관활성약물、6 hEGDT 체표솔차이구유통계학의의(P<0.05);②24 h내적관리집속화치료중:관찰조재혈당공제、소제량적당피질격소사용솔이급보호성폐통기책략상화대조조적비교차이구유통계학의의(P<0.05);③통과량조적림상비교,관찰조적궤계통기시간、입주ICU적시간비교차이무통계학의의(P>0.05).결론 이6 h화24 h감염성휴극집속화치료위핵심적림상도경,가이제고ICU 의사대SSC지남적조작,강저환자감염성휴극적사망솔여감염솔.
Objective To investigate the clinical effect of bundle treatment for septic shock. Methods 60 patients with septic shock admitted to the ICU of Kezhou People's Hospital between May 2011 and December 2012 were randomly selected. They were assigned to undergo conventional therapy (the control group, n=30) and 6h and 24h bundle group (the observation group, n=30). The clinical efficacy was compared between the two groups. Results In the 6h bundle treatment, in terms of preliminary diagnosis time, blood culture before the use of antibiotics, detection rate of serum lactic acid, central Venous Catheterization within 2h, empirical antibiotics treatment within 1h, use of vasoactive agents, 6hEGDT compliance rate, there was statistically significant difference between the two groups (P<0.05). In the 24 h bundle treatment, in terms of blood glucose control, use of small dose of glucocorticoid, and protective lung ventilation strategy, there was statistically significant difference, P<0.05. In terms of duration of mechanical ventilation and lengthy of ICU stay, there was no statistically significant difference between the two groups, P<0.05. Conclusion The clinical therapeutic approach with 6h and 24h bundle treatment in the core can improve ICU physician's performance according to the SSC guide, and reduce the mortality and infection rate.