氢化可的松琥珀酸钠给药方式差异对重症脓毒血症继发休克患者生命体征、动态血糖指标及死亡率的影响

发布时间：2018-07-22 12:05

【摘要】：目的探讨氢化可的松琥珀酸钠静脉滴注与微量泵注给药对重症脓毒血症继发休克患者生命体征、动态血糖指标及死亡率的影响。方法选取该院2014年6月-2016年6月收治重症脓毒血症继发休克患者共100例。采用随机数字表法分为A组(50例)和B组(50例),在常规对症干预基础上分别给予氢化可的松琥珀酸钠静脉滴注与微量泵注给药。比较两组患者休克持续时间、ICU住院时间、总住院时间、28 d死亡率、治疗前后生命体征指标、治疗后血乳酸清除率和动态血糖监测指标水平。结果两组患者休克持续时间,ICU住院时间及总住院时间比较差异无统计学意义(P0.05);两组患者28 d内死亡率比较差异无统计学意义(P0.05);两组患者治疗前后HR、MAP及CVP水平组间比较差异无统计学意义(P0.05);两组患者治疗后6、24及48 h血乳酸清除率比较差异无统计学意义(P0.05);两组患者平均血糖值(MBG)水平比较差异无统计学意义(P0.05);但B组患者最大血糖波动幅度(LAGE)、血糖波动系数(GV)及高血糖时间窗水平均低于A组(P0.05)。结论氢化可的松琥珀酸钠2种给药方式治疗重症脓毒血症继发休克临床疗效相当,但微量泵注给药方式应用可有效提高血糖稳定性,维持机体代谢平衡。
[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.
【作者单位】：天津市天津医院内科ICU;
【分类号】：R459.7

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