集束化管理策略对脓毒症患者免疫功能及预后的影响  

Effects of the cluster management strategy on immune function and prognosis of sepsis patients

作　　者：王静 庄金强 陈敏 夏乐[1] 孙颖 WANG Jing;ZHUANG Jinqiang;CHEN Min(Department of Emergency,Affiliated Hospital of Yangzhou University,Jiangsu,Yangzhou 225009,China)

机构地区：[1]扬州大学附属医院急诊科,江苏省扬州市225009

出　　处：《河北医药》2024年第12期1842-1845,共4页Hebei Medical Journal

基　　金：2023年扬州大学心脏大血管研究院开放课题(编号:YIHV0001)。

摘　　要：目的分析集束化管理策略对脓毒症患者免疫功能及预后的影响。方法选取2022年4月至2023年4月收治的82例脓毒症患者作为研究对象,按入院就医时间的不同将所有患者分为对照组和观察组,每组41例。对照组接受常规治疗和干预措施,观察组在对照组基础上接受集束化管理策略干预,评估和比较2组患者免疫功能指标、炎症指标、血流动力学指标以及预后效果。结果干预后观察组CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)高于对照组(P<0.05),而CD_(8)^(+)、白细胞计数(WBC)水平低于对照组(P<0.05);干预后2组IL-6、CRP以及PCT水平均有所降低,组间比较,观察组低于对照组(P<0.05);观察组心率(HR)较于对照组低(P<0.05),而其平均动脉压(MAP)和中心静脉压(CVP)高于对照组(P<0.05);观察组在血管活性药物使用时间、机械通气时间以及总住院时间方面与对照组相比,显示明显地缩短且差异有统计学意义(P<0.05)。结论在脓毒症患者干预中,采取集束化管理策略可取得显著的干预效果,能有效改善免疫功能、降低炎症因子水平、稳定血流动力学,并促进预后效果提高。Objective To analyze the effects of the cluster management strategy on immune function and prognosis of sepsis patients.Methods Eighty-two sepsis patients admitted to our hospital between April 2022 and April 2023 were selected as the study subjects.They were assigned into the control group(No.1-41)and the observation group(No.42-82)according to the sequence of admission.All patients received conventional treatments and interventions,and those in the observation group additionally received cluster management strategy.Immune function indicators,inflammatory indicators,hemodynamic indicators,and prognostic effects between the two groups were compared.Results After the intervention,CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)levels in the observation group were significantly higher than those of the control group(P<0.05),while CD_(8)^(+)level and white blood cell count(WBC)were significantly lower(P<0.05).After the intervention,interleukin 6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)levels significantly decreased in both groups than those before the intervention,which were significantly lower in the observation group than those of the control group(P<0.05).The heart rate(HR)of the observation group was significantly lower than that of the control group(P<0.05),while the mean arterial pressure(MAP)and central venous pressure(CVP)were significantly higher(P<0.05).The use time of vasoactive drugs,duration of mechanical ventilation and total hospitalization time in the observation group were significantly shorter than those of the control group(P<0.05).Conclusion The cluster management strategy can achieve significant intervention effects on sepsis patients,which can effectively improve immune function,reduce inflammatory factors,stabilize hemodynamics,and promote the prognosis.

关 键 词：集束化管理策略 脓毒症 免疫功能 炎症指标 血流动力学 

分 类 号：R59[医药卫生—内科学]