激素在重症社区获得性肺部感染并发脓毒性休克患者治疗中的应用效果研究  

Effect of hormone in patients with severe community acquired pulmonary infection complicated with septic shock

作　　者：肖文 XIAO Wen(ICU,The People's Hospital of Yongcheng City,Henan 476600,China)

机构地区：[1]河南省永城市人民医院重症医学科

出　　处：《淮海医药》2020年第1期28-30,共3页Journal of Huaihai Medicine

摘　　要：目的:探讨激素在重症社区获得性肺部感染并发脓毒性休克患者治疗中的应用效果。方法:选择某院就诊的重症社区获得性肺部感染并发脓毒性休克患者96例,按照随机数表法分为研究组和对照组,每组各48例。所有患者均采用常规治疗方法,研究组加用糖皮质激素治疗,患者入院24 h内抽血检验血常规,比较2组患者归转时间、临床肺部感染评分及不良反应发生率。结果:研究组患者升压药停用时间、休克逆转时间及机械通气停用时间均少于对照组,差异有统计学意义(P<0.05);治疗后,2组患者的血清降钙素原(PCT)、C反应蛋白(CRP)、血乳酸水平(LAC)水平均明显降低,且研究组低于对照组,差异有统计学意义(P<0.05);研究组患者肺部感染各项评分明显低于对照组,差异有统计学意义(P<0.05);2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论:糖皮质激素能够显著改善重症社区获得性肺部感染并发脓毒性患者的归转时间、肺部感染状况,小剂量糖皮质激素具有较好的安全性,值得临床推广应用。Objective:To study the effect of hormone in patients with severe community-acquired pneumonia complicated with septic shock.Methods:96 cases of septic shock patients with pulmonary infection were selected and randomly divided into a study group and a control group,48 cases in each.The control group was treated with routine treatment, and patients in the study group were given glucocorticoid on the basis of the control group.All the patients were examined within 24 h in admission for blood routine. The prognosis condition, clinical pulmonary infection score and adverse reactions were compared between the two groups.Results:The study group patients vasopressors discontinuation time, shock reversal time and mechanical ventilation withdrawal time were earlier or shorter than the control group(P<0.05).After treatment,PCT,CRP and LAC levels of the two groups significantly decreased, with the study group’s more significantly than those of the control group(P<0.05).The clinical evaluation scores of pulmonary infection of the study group were significantly lower than those of the control group(P<0.05).There was no significant difference between the two groups in terms of adverse reactions(P>0.05).Conclusion:Glucocorticoid can significantly improve the infection status for patients with community acquired pulmonary complicated with septic shock.Small doses of glucocorticoids have better safety. It is worthy of clinical application.

关 键 词：肺部感染 激素 脓毒性休克 社区 

分 类 号：R563[医药卫生—呼吸系统]