作　　者： (吴先龙）; (周燕飞）; (张盛）; (杨志辉）; (蔡旗旗）; (应盼）;

机构地区： 台州市第一人民医院EICU,浙江台州318020

出　　处： 《中华医院感染学杂志》 2017年第15期3427-3430,共4页

摘　　要： 目的研究集束化治疗依从率对脓毒血症休克患者的疗效及预后情况,为临床治疗提供参考依据。方法分析2013年1月-2014年6月于医院接受治疗的78例脓毒血症休克患者的临床资料,将42例接受集束化治疗的患者列为观察组,把36例采用常规治疗的脓毒血症休克患者纳为对照组;观察两组患者依从性和相关预后指标。结果 78例脓毒血症休克患者感染病原菌主要以革兰阴性菌感染为主,占70.51%;观察组患者6h、24h时的平均动脉压(MAP)、中心静脉压(CVP)、中心静脉血氧饱和度(ScvO_2)、动脉血乳酸水平高于对照组,差异有统计学意义(P<0.05);治疗后,观察组患者的住院时间、急性生理与慢性健康(APACHE Ⅱ)评分、序贯器官衰竭估计(SOFA)评分显著低于对照组,差异有统计学意义(P<0.05);集束化治疗依从组患者的28d生存率显著高于常规治疗依从组患者,差异有统计学意义(P<0.05)。结论提高医务人员对于脓毒血症休克治疗的依从性可以有效改善患者血液循环功能,降低患者的病死率,对于脓毒血症休克早期的治疗具有良好的临床实用价值。 OBJECTIVE To investigatethe curative effect and prognosis of bundle treatment compliance rate for the patients with sepsis shock,so as to provide references for clinical treatment.METHODS The clinical data of 78 patients with sepsis shock in our hospital from Jan.2013 to Jun.2014 were analyzed.Totally 42 cases of patients with bundle treatment were treated as observation group,and 36 cases of patients with normal treatment of sepsis shock patients were treated as control group.The compliance and related prognostic indexes of the two groups were observed.RESULTS The main pathogens of infection of 78 cases of septic shock patients were gram-negative bacteria,accounting for 70.51% .The MAP,CVP,ScvO_2 and blood lactic acid level in observation group at 6 h and 24 h were higher than those in control group,and the differences were significant（P〈0.05）.After treatment,the hospital stay,APACHE Ⅱ score and SOFA score of observation group were significantly lower than those of control group（P〈0.05）.The 28 days survival rate in observation group for the bundle treatment was significantly higher than that of conventional treatment compliance group of patients（P〈0.05）.CONCLUSION Improving the compliance of medical staff for sepsis shock treatment can effectively improve blood circulation function and reduce the mortality of patients,which has a good clinical practical value for the early treatment of sepsis shock.

关 键 词： 集束化治疗 依从率 脓毒血症 休克