早期镇静镇痛治疗对感染性休克患者的影响  

Influence of early calm analgesic therapy in patients with septic shock

作　　者：陈燕[1] 李书清[1] 梅海峰[2] 赵月香[1] 

机构地区：[1]江苏省泰州市中医院,江苏泰州225300 [2]江苏省泰州市人民医院,江苏泰州225300

出　　处：《现代中西医结合杂志》2015年第4期353-355,358,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：泰州市社会发展项目(TS201237)

摘　　要：目的探讨早期镇静镇痛治疗对感染性休克患者的影响。方法采用回顾性队列研究方法,将94例根据感染性休克复苏指南常规治疗者作为对照组,将98例在常规治疗基础上进行早期镇静镇痛治疗者作为治疗组。比较2组患者急性生理和慢性健康评分(APACHEⅡ评分)、感染相关器官功能衰竭评分系统(SOFA)评分、机械通气时间、住ICU时间、28 d病死率、早期复苏目标(EGDT)达标率。结果治疗后2组APACHEⅡ评分、SOFA评分均有下降(P均<0.01),但治疗组下降更明显(P均<0.01);治疗组机械通气时间、住ICU时间均较对照组明显缩短(P<0.01和P<0.05);对照组与治疗组28 d病死率分别为46%和32%,2组相比差异有统计学意义(P<0.05);对照组EGDT达标率为88%,治疗组为91%,2组相比差异无统计学意义。结论早期镇静镇痛治疗能显著改善感染性休克患者疾病发展进程,缩短机械通气时间及住ICU时间,降低28 d病死率。Objective It is to investigate the influence of early calm analgesic theraphy in the patients with septic shock.Methods A retrospective study was deployed. Totally one hundred and ninety-two critical patients suffering from severe septic shock were divided into control group（ n = 94） treated with conventional therapy recommended by septic shock resuscitation guidelines and treatment group（ n = 98） treated with early analgesic and sedative therapy on the basis of normal treatment. The difference of the rate of reaching the early goal,SOFA score,APACHEⅡ score and the duration of mechanical ventilation,the length of ICU stay,28- day mortality were compared between the two groups. Results After treatment,the SOFA score and the APACHEⅡ score in both groups decreased totally（ P〈0. 01）,while the scores decreased more greatly in treatment group. The duration of mechanical ventilation and the length of ICU stay were shorter in treatment group than that in control group（ P〈0. 01 and P〈0. 05）; In comparison with two groups,there were highly significant difference（ P〈0. 01）. The length of ICU in therapeutical group shortened too. The 28- day mortality in the control group were 46%,while in treatment group were 32%.In comparison with two groups,there was significant difference（ P〈0. 05）. The rate of reaching the early goal in control group was 88% and 91% in treatment group,the difference was not significant between the two groups（ P〈0. 05）. Conclusion Early calm analgesic theraphy can remarkably decrease the severity of illness,decrease the duration of mechanical ventilation,and decrease the 28- day mortality.

关 键 词：感染性休克 镇静镇痛 早期复苏目标 机械通气时间 28 d病死率 

分 类 号：R48[医药卫生—临床医学]