氢化可的松琥珀酸钠持续静脉微量泵入治疗重症脓毒性休克的效果观察  

Effects of hydrocortisone sodium succinate continuous intravenous infusion in the treatment of severe septic shock

作　　者：杨勇[1] 邓湘辉[1] 何润芝[1] 黄佳[1] YANG Yong;DENG Xianghui;HE Runzhi;HUANG Jia(Department of Critical Care Medicine,Changsha Central Hospital,Changsha 410004,Hunan,China)

机构地区：[1]长沙市中心医院重症医学科

出　　处：《中国临床药理学与治疗学》2018年第11期1297-1301,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:探讨氢化可的松琥珀酸钠持续静脉微量泵入治疗重症脓毒性休克对患者住院时间、动态血糖指标以及部分生命体征的影响。方法:选取长沙市中心医院2017年1月至2018年2月142例重症脓毒性休克患者为研究对象,随机分为研究组与对照组,每组71例。在常规治疗的基础上给予研究组氢化可的松琥珀酸钠持续静脉微量泵入治疗,给予对照组氢化可的松琥珀酸钠静脉滴注治疗,观察两组患者总住院时间、ICU住院时间、休克持续时间、部分生命体征指标、动态血糖指标、血乳酸清除率等情况。结果:两组患者经过治疗之后,研究组患者总住院时间、ICU住院时间、休克持续时间均少于对照组(P <0. 05);并且研究组患者心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)等指标水平均明显优于对照组(P<0. 05);另一方面,研究组患者的血糖波动系数、最大血糖波动幅度、高血糖时间窗等水平也显著优于对照组;治疗后研究组患者的血乳酸清除率显著高于对照组(P <0. 05)。结论:氢化可的松琥珀酸钠持续静脉微量泵入治疗重症脓毒性休克临床疗效较好,微量泵入能提高患者机体代谢水平与血糖稳定性,可在临床上推广应用。AIM: To investigate the effects of continuous intravenous microinfusion of hydrocortisone sodium succinate on hospitalization time, dynamic glycemic index and some vital signs in patients with severe septic shock. METHODS: A total of 142 cases of severe septic shock were selected in our hospital from January 2017 to February 2018 and were randomly divided into the study group and the control group, with 71 cases in each group. The study group was given hydrocortisone sodium succinate intravenous micro pump based on routine treatment, while control group received hydrocortisone sodium succinate intravenous drip treatment, the total hospitalization time, ICU hospitalization time and duration of shock, part of vital signs index, dynamic blood glucose index, blood lactate clearance etc. were observed and compared between two groups. RESULTS: After treatment, the total hospitalization time, ICU hospitalization time and duration of shock of the study group were less than those of the control group (P<0.05); and the heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP) and other indicators were significantly better than those of the control group (P<0.05). And the blood glucose fluctuation coefficient, maximum blood glucose fluctuations and high blood glucose level time window of the study group were significantly better than those of the control group; After treatment, blood lactate clearance rate of patients in the study group was significantly higher than that of the control group (P<0.05). CONCLUSION: Continuous intravenous microinfusion of hydrocortisone sodium succinate is effective in treating severe septic shock. Micropump can improve the metabolism level and blood glucose stability of patients, and it can be widely applied in clinic.

关 键 词：持续 静脉微量 泵入 重症脓毒性 休克 效果 观察 

分 类 号：R441.9[医药卫生—诊断学] R459.3[医药卫生—临床医学]