儿童严重脓毒症亚低温治疗对器官功能保护作用的研究  

Organ Function Protective Effect Research of Mild Hypothermia Therapy on Children with Severe Sepsis

作　　者：李立浩[1] 马力忠[2] 梁桂明[2] 李正然[2] 莫庆仪[2] 王丽[2] 付四毛[2] 

机构地区：[1]中山市陈星海医院,广东中山528400 [2]中山市博爱医院,广东中山528400

出　　处：《儿科药学杂志》2014年第10期8-11,共4页Journal of Pediatric Pharmacy

基　　金：广东省中山市科学技术项目;项目编号20122A185

摘　　要：目的：探讨亚低温治疗对严重脓毒症患儿重要器官功能的保护作用。方法：选择中山市博爱医院儿科2007年1月至2013年9月诊断为感染性休克、严重脓毒症、多器官功能衰竭且住院48 h以上的患儿,共73例,随机分为亚低温治疗组32例和常规对照组41例,对照组给予常规治疗,治疗组在常规治疗基础上加用亚低温治疗（肛温34~36℃）,记录并分析两组患儿的体温、心率、谷丙转氨酶（ALT）、谷草转氨酶（AST）、肌酸激酶（CK）、心肌型肌酸激酶同工酶（CK-MB）、血清尿素氮（BUN）、肌酐（Cr）、乳酸、血小板（PLT）、凝血时间（PT）、部分凝血酶原时间（APTT）。结果：治疗后治疗组的心率、CK、CK-MB、AST、ALT水平低于对照组（P〈0.05）;BUN、Cr、PLT水平及PT、APTT、院内感染率两组患儿比较差异无统计学意义（P〉0.05）;两组患儿的病死率比较差异无统计学意义（P〉0.05）,但治疗组死亡病例院内存活时间较对照组长（P〈0.05）。结论：亚低温对严重脓毒症患儿的心脏和肝脏功能有一定保护作用。Objective： To investigate the vital organ function protective effect of mild hypothermia therapy on children with severe sepsis. Methods： Clinical data of critically ill children with severe sepsis were analyzed. 73 cases who were admitted to Bo＇ ai Hospital from Jan 2007 to Sept 2013 with severe sepsis were divided into treatment group （ n = 32 ） and control group （ n = 41 ）. The treatment group was administered by mild hypothermia （ rectal temperature 34 - 36 ℃ ）. The control group was managed routinely. Temperature （ T）, heart rate （HR）, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, creatine kinase （CK）, creatine kinase-MB isoenzyme （CK-MB） , blood urea nitrogen （ BUN ） , creatinine （Cr） , lactate, platelet （PLT） , prothrombin time （PT） , activated partial thromboplastin time （APTT） were recorded and analyzed after admission. Results： The level of HR, ALT, AST, CK, CK-MB in treatment group were lower than that of control group （P〈0.05）. The level of BUN, Cr, PLT, and PT, APTT has no significant difference （ P〉0.05 ）. There were no statistical significance in mortality between control group and treatment group （ P〉0.05 ） , but the survival time of deaths in the treatment group was longer than that of control group. Conclusion： Mild hypothermia was effective in protecting liver and heart function on children with severe sepsis.

关 键 词：亚低温 脓毒症 儿童 

分 类 号：R720.597[医药卫生—急诊医学]