2016年至2020年江苏省内医院重症医学科感染性休克患者集束化治疗的现状  

Completion rates of bundle treatment of among patients with sepsis shock in intensive care departments of hospitals in Jiangsu Province from 2016 to 2020 years

作　　者：陈伟伟 谢剑锋[1] 杨毅[1] 杨从山[1] Chen Weiwei;Xie Jianfeng;Yang Yi;Yang Congshan(Department of Critical Care Medicine,Zhongda Hospital,School of Medicine,Southeast University,Jiangsu Provincial Key Laboratory of Critical Care Medicine,Nanjing 210009,China)

机构地区：[1]东南大学附属中大医院重症医学科、江苏省重症医学重点实验室,南京210009

出　　处：《中华内科杂志》2023年第5期545-549,共5页Chinese Journal of Internal Medicine

基　　金：国家自然科学基金面上项目(82072155,81971888)。

摘　　要：调查2016—2020年江苏省内医院重症医学科/ICU感染性休克患者3 h、6 h集束化治疗完成率,分析感染性休克救治完成现状及原因。分析2016年至2020年上报江苏省重症医学专业医疗质量控制中心数据平台的江苏省内二、三级医院重症医学科/ICU收治的感染性休克患者的相关资料,记录江苏省内不同城市、不同级别医院重症医学科/ICU感染性休克患者3 h、6 h集束化治疗完成率。结果显示,2016—2020年江苏省内各医疗单位重症医学科/ICU感染性休克患者3 h、6 h集束化治疗完成率逐年提高,3 h集束化治疗完成率从69.82%(3604/5162)升至82.47%(8915/10775),差异有统计学意义(均P<0.001)。6 h集束化治疗完成率从62.69%(3236/5162)升至72.54%(7816/10775),差异有统计学意义(均P<0.001)。三级医院重症医学科/ICU感染性休克患者集束化治疗完成率逐年提高,3 h集束化治疗完成率从69.80%(3596/5152)升至82.23%(7375/8969),6 h集束化治疗完成率从62.69%(3230/5152)升至72.18%(6474/8969),差异有统计学意义(均P<0.001)。二级医院重症医学科/ICU感染性休克患者集束化治疗完成率亦逐年提高,3 h集束化治疗完成率从80.00%(8/10)升至85.27%(1540/1806),6 h集束化治疗完成率从60.00%(6/10)升至74.31%(1342/1806),差异有统计学意义(均P<0.001)。3 h集束化治疗完成率一线城市[83.99%(2099/2499)]、二线城市[84.68%(3952/4667)]均高于三线城市[79.36%(2864/3609)],6 h集束化治疗完成率一线城市[77.19%(1929/2499)]、二线城市[74.37%(3471/4667)]、三线城市[66.94%(2416/3609)]逐渐降低(均P<0.001)。近5年来江苏省内医院重症医学科/ICU在感染性休克患者的集束化治疗完成率有着显著改善。Current clinical approaches for septic shock increasingly incorporate bundle treatment,a multi-component approach that uses a collection of tests and agents to assist in the identification and treatment of infection.The present study analyzed completion rates of 3 h and 6 h bundle treatment among patients with septic shock in intensive care units(ICUs)of hospitals in Jiangsu Province from 2016 to 2020,using data from the Jiangsu Provincial Intensive Care Medical Quality Control Center.Current approaches and factors affecting treatment completion were assessed.The completion rates of 3 h and 6 h bundle treatment in ICUs of all medical units in Jiangsu Province and in ICUs of hospitals of different levels were recorded.Analyses show that the completion rate of 3 h and 6 h bundle treatment for patients with septic shock in ICUs in Jiangsu Province increased year by year from 2016 to 2020.The completion rate of 3 h bundle treatment increased from 69.82%(3604/5162)to 82.47%(8915/10775)(all P<0.001).The completion rate of 6 h bundle treatment increased from 62.69%(3236/5162)to 72.54%(7816/10775)(all P<0.001).In addition,year by year,the completion rate of 3 h bundle treatment in ICUs in tertiary hospitals increased,from 69.80%(3596/5152)to 82.23%(7375/8969),while the completion rate of 6 h bundle treatment increased from 62.69%(3230/5152)to 72.18%(6474/8969)(all P<0.001).Completion rates in secondary hospitals also increased year by year,from 80.00%(8/10)to 85.27%(1540/1806)for 3 h treatment and from 60.00%(6/10)to 74.31%(1342/1806)(all P<0.001)for 6 h treatment.Completion rates for 3 h treatment in first-tier cities(83.99%(2099/2499))and second-tier cities(84.68%(3952/4667))was higher than in third-tier cities(79.36%(2864/3609)).The completion rate of 6 h bundle treatment gradually decreased in first-line(77.19%(1929/2499)),second-line(74.37%(3471/4667)),and third-line(66.94%(2416/3609))cities(all P<0.001).The data collectively show that from 2016 to 2020,the completion rate of bundle treatment in septic shock patient

关 键 词：休克 脓毒性 集束化治疗 3小时 6小时 质量控制 

分 类 号：R459.7[医药卫生—急诊医学]