氢化可的松琥珀酸钠不同给药方式对重症脓毒性休克患者的影响

发布时间：2018-05-06 02:34

本文选题：氢化可的松 + 休克　；参考：《重庆医学》2017年24期

【摘要】：目的研究氢化可的松琥珀酸钠静脉滴注和持续静脉微量泵入对重症脓毒性休克患者生命体征、休克持续时间、血糖及病死率的影响。方法选择2014年6月至2016年9月在该院重症医学科接受治疗的脓毒性休克患者90例。用随机数表法分为对照组和观察组,每组各45例,对照组给予氢化可的松琥珀酸钠200mg/d缓慢静脉滴注2h,观察组持续静脉微量泵入氢化可的松琥珀酸钠8.33mg/h,两组连续治疗5d。比较两组患者的血糖指标、血流动力学和预后。结果观察组患者的高血糖时间窗、最大血糖波动幅度、平均血糖水平、血糖波动系数水平等血糖指标低于对照组,差异有统计学意义(P0.05)。两组患者治疗前、治疗后6h、治疗后24h和治疗后5d的心率、中心静脉压和平均动脉压等血流动力学指标比较,差异无统计学意义(P0.05)。观察组患者的休克持续时间、ICU住院时间、总住院时间和28d病死率低于对照组,但两组比较差异无统计学意义(P0.05)。结论持续静脉微量泵入氢化可的松琥珀酸钠可以稳定脓毒性休克患者的血糖波动幅度,但是血流动力学指标和预后无明显改善。
[Abstract]:Objective to study the effects of hydrocortisone sodium succinate intravenous drip and continuous intravenous infusion on vital signs, duration of shock, blood glucose and mortality in patients with severe septic shock. Methods from June 2014 to September 2016, 90 patients with septic shock were selected. The patients were divided into control group (n = 45) and observation group (n = 45). The control group was treated with hydrocortisone sodium succinate (200mg/d) slowly intravenously for 2 hours, and the observation group received continuous intravenous infusion of hydrocortisone sodium succinate (8.33 mg / h) for 5 days. Blood glucose index, hemodynamics and prognosis were compared between the two groups. Results in the observation group, the hyperglycemia time window, the maximum fluctuation range of blood sugar, the average blood sugar level and the blood glucose fluctuation coefficient were lower than those in the control group, and the difference was statistically significant (P 0.05). There was no significant difference in heart rate, central venous pressure and mean arterial pressure between the two groups before treatment, 6 hours after treatment, 24 hours after treatment and 5 days after treatment. The duration of shock and duration of ICU, total hospitalization time and fatality rate of 28 days in the observation group were lower than those in the control group, but there was no significant difference between the two groups (P 0.05). Conclusion continuous intravenous infusion of hydrocortisone sodium succinate can stabilize the fluctuation of blood glucose in patients with septic shock, but there is no significant improvement in hemodynamics and prognosis.
【作者单位】：四川省内江市第一人民医院重症医学科;
【分类号】：R459.7

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