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目的探讨微量泵输入小剂量氢化可的松对顽固性感染性休克患者血流动力学、血糖波动及预后的影响。方法将72例顽固性感染性休克患者随机分为观察组和对照组,观察组给予静脉微量泵入氢化可的松治疗,对照组给予静脉滴注氢化可的松,对比两组治疗前后血流动力学、血糖波动及预后情况。结果观察组T3、T4和T5时刻的HR水平显著低于对照组,而T2、T3、T4和T5时刻的MAP和EF水平显著高于对照组(P<0.05);观察组休克持续时间显著短于对照组(P<0.05),而两组间各时期CVP水平以及MBG、GV、LAGE、高血糖时间窗、总住院时间、ICU住院时间和28d病死率差异均无统计学意义(P>0.05)。结论与静脉滴注相比,静脉微量泵入氢化可的松可有效改善血流动力学、稳定血糖波动和缩短休克时间。
Objective To investigate the effects of low-dose hydrocortisone on hemodynamics, blood glucose fluctuation and prognosis in patients with refractory septic shock. Methods A total of 72 patients with intractable septic shock were randomly divided into observation group and control group. The observation group was given intravenous micro-pump of hydrocortisone, while the control group was given intravenous hydrocortisone. The blood flow before and after treatment Kinetics, blood glucose fluctuations and prognosis. Results The levels of HR at T3, T4 and T5 in observation group were significantly lower than those in control group, while the levels of MAP and EF at T2, T3, T4 and T5 were significantly higher than those in control group (P <0.05). The duration of shock in observation group was significantly shorter (P <0.05). There was no significant difference in CVP level, MBG, GV, LAGE, hyperglycemia time window, total length of hospital stay, length of ICU stay and 28d mortality between the two groups (P> 0.05 ). Conclusion Compared with intravenous drip, intravenous micro-injection of hydrocortisone can effectively improve hemodynamics, stabilize blood sugar fluctuations and shorten the shock time.