氢化可的松琥珀酸钠静脉滴注和静脉泵入治疗重症脓毒血症继发休克的疗效差异  

The difference of therapeutic effect of intravenous drip and intravenous pumping of hydrocortisone sodium succinate in the treatment of severe sepsis secondary shock

作　　者：郑小红 ZHENG Xiao-hong(Department of Critical Medicine,Chengfei Hospital,Chengdu 610091,China)

机构地区：[1]成飞医院重症医学科,610091

出　　处：《中国现代药物应用》2020年第6期10-13,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨氢化可的松琥珀酸钠通过静脉滴注和静脉泵入两种方式治疗重症脓毒血症继发休克的效果和安全性差异。方法 70例重症脓毒血症继发休克患者,以随机数字表法分为对照组及观察组,各35例。两组均接受氢化可的松琥珀酸钠治疗,对照组予以静脉滴注给药方式,观察组予以静脉泵入给药方式。比较两组患者的血糖、血压、乳酸水平,疗效、不良反应发生情况。结果观察组血糖波动系数(GV)、最大血糖波动幅度(LAGE)、平均血糖水平(MBG)分别为(2.49±0.71)、(17.08±5.47)、(8.59±1.96)mmol/L,均低于对照组的(3.25±1.03)、(22.63±7.15)、(10.12±3.28)mmol/L,差异有统计学意义(P<0.05)。两组患者的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)水平对比,差异无统计学意义(P>0.05)。两组患者治疗前、治疗12 h、治疗24 h、治疗48 h的乳酸水平对比,差异无统计学意义(P>0.05)。两组休克时间、住重症加强护理病房(ICU)时间及住院时间对比,差异无统计学意义(P>0.05)。观察组水钠潴留、应激性出血、精神异常、荨麻疹发生率分别为11.43%、0、2.86%、2.86%,与对照组的17.14%、0、0、5.71%对比,差异无统计学意义(P>0.05)。结论氢化可的松琥珀酸钠通过静脉滴注和静脉泵入治疗重症脓毒血症继发休克患者均能获得显著临床疗效,但静脉泵入治疗对患者血糖水平波动影响相对更小。Objective To discuss the differences of effect and safety of intravenous drip and intravenous pumping of hydrocortisone sodium succinate in the treatment of severe sepsis secondary shock. Methods A total of 70 cases of severe sepsis secondary shock were divided into control group and observation group by random number table method, with 35 cases in each group. Both groups were treated by hydrocortisone sodium succinate. The control group received intravenous drip administration, and the observation group received intravenous pump administration. The blood glucose, blood pressure, lactate level, efficacy, and occurrence of adverse reactions were compared between the two groups. Results The glucose variability(GV), largest amplitude of glycemic excursions(LAGE), mean blood glucose(MBG) were(2.49±0.71),(17.08±5.47) and(8.59±1.96) mmol/L respectively in the observation group, which were all lower than(3.25±1.03),(22.63±7.15) and(10.12± 3.28) mmol/L in the control group, and their difference was statistically significant(P<0.05). There was no statistically significant difference in systolic blood pressure(SBP), diastolic blood pressure(DBP), and mean arterial pressure(MAP) levels between the two groups(P>0.05). Before treatment, 12 h, 24 h and 48 h after treatment, there was no statistically significant difference in levels of lactate between the two groups(P>0.05). There was no statistically significant difference in shock time, time in intensive care unit(ICU) and hospitalization time between the two groups(P>0.05). The incidence of sodium retention, stress bleeding, mental disorders, urticaria were 11.43%, 0, 2.86% and 2.86% respectively in the observation group, which had no statistically significant difference compared with 17.14%, 0, 0 and 5.71% in the control group(P>0.05). Conclusion Hydrocortisone sodium succinate through intravenous infusion and intravenous pumping can achieve significant clinical efficacy in patients with severe sepsis secondary shock. However, intravenous pumping has a relatively sma

关 键 词：氢化可的松琥珀酸钠 脓毒血症 静脉泵入 休克 静脉滴注 

分 类 号：R459.7[医药卫生—急诊医学]