小儿胃肠功能障碍早期诊治对感染性休克预后的研究  

Early diagnosis and treatment of pediatric gastrointestinal dysfunction for research on the prognosis of septic shock

作　　者：吴卫萍[1] 万秋清[1] 朱友荣[1] 袁爱群[1] 

机构地区：[1]江西省儿童医院,南昌330006

出　　处：《江西医药》2013年第10期857-860,共4页Jiangxi Medical Journal

摘　　要：目的探讨感染性休克患儿胃肠功能障碍的早期诊断与干预对预后的影响。方法 30例感染性休克患儿根据有无胃肠功能障碍及程度分成3组,测定其胃肠黏膜内pH值、血清D-乳酸水平,并分析3组感染性休克患儿好转率。结果 (1)感染性休克未出现胃肠功能障碍组经治疗后好转出重症监护室比率为90%,出现早期胃肠功能障碍组经干预后好转率为80%,而中晚期胃肠功能障碍组虽经积极治疗好转率为30%,经卡方检验,好转率差异有显著性(P<0.01);(2)胃肠黏膜内pH值(pHi)值3组分别为(7.32±0.03)、(7.29±0.02)、(7.23±0.08),差异有显著性(P<0.01);(3)3组血浆D-乳酸水平分别为(7.42±1.57)mg/L、(9.10±1.23)mg/L、(13.69±2.38)mg/L,差异有显著性(P<0.01)。结论感染性休克患儿的预后与胃肠功能障碍的出现及程度有关,一旦出现胃肠功能损伤,且胃肠功能障碍程度越重,好转率下降,死亡率增加。胃肠黏膜内pH值及血浆D-乳酸水平可有助于早期诊断胃肠功能障碍并有助于判断感染性休克患儿的预后。Objective To explore the prognosis with septic shock when early diagnosis and treatment of gastrointestinal dys-function in children. Methods 30 cases of children with septic shock were divided into three groups according to the presence and degree of gastrointestinal dysfunction. PH value in gastric mucosa and plasma D-Lactate were performed ,and the improvement rates were be analyzed in the three groups. Results The improvement rate of the group that no appearing gastrointestinal dys-function with septic shock after treatment was 90%;In the group with early gastrointestinal dysfunction,the improvement rate was 80%,and although the middle and advanced stage gastrointestinal dysfunction group were taked active treatment ,the improvement rate was 30%;There were significant difference （P〈0.01）. pH in Gastrointestinal mucosa of 3 groups were（7.32±0.03）、（7.29±0.02）、（7.23±0.08）respectively,there is a very significant difference（P〈0.01）. Plasma D-lactic acid levels of three groups were（7.42±1.57） mg/L、（9.10±1.23） mg/L、（13.69±2.38） mg/L respectively （P〈0.01）. Conclusion The prognosis of children with septic shock is as-sociated with the occurrence and degree of gastrointestinal dysfunction. PH value in gastric mucosa and the plasma D-Lactate levels maybe help to early diagnosis of gastrointestinal dysfunction and determine the prognosis of septic shock.

关 键 词：感染性休克 胃肠功能障碍 儿童 早期诊治 预后 

分 类 号：R725.7[医药卫生—儿科]