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目的:探讨氢化可的松琥珀酸钠对严重脓毒症患者临床疗效及预后的影响。方法:62例严重脓毒症患者随机分为治疗组32例与对照组30例,两组均给予常规治疗,在常规治疗的基础上治疗组加用小剂量氢化可的松琥珀酸钠,观察治疗前及治疗后72h、168hPCT和CRP;0h、24h、48h、168h行急性生理功能和慢性健康状况(APACHEⅡ)评分和序贯性器官衰竭评分(SOFA评分);比较两组28d病死率。结果:治疗前两组患者上述各指标差异无统计学意义(P>0.05)。治疗后两组各时点PCT和CRP浓度均明显下降(P<0.05),治疗后24h、48h、168hAPACHEⅡ评分、SOFA评分均明显下降(P<0.05),治疗组各时间点各指标的下降程度更为显著(P<0.05);但两组患者28d病死率差异无统计学意义。结论:小剂量氢化可的松琥珀酸钠能减轻严重脓毒症患者的炎症反应,对改善病情预后有一定的价值。
Objective: To investigate the effect of hydrocortisone sodium succinate on clinical efficacy and prognosis in patients with severe sepsis. Methods: Sixty-two patients with severe sepsis were randomly divided into treatment group (32 cases) and control group (30 cases). Both groups were given conventional treatment. On the basis of conventional treatment, the treatment group was treated with low-dose hydrocortisone sodium succinate and observed Pre-treatment and post-treatment 72h, 168hPCT and CRP; 0h, 24h, 48h, 168h acute physiology and chronic health status (APACHE Ⅱ) score and sequential organ failure score (SOFA score); Results: There was no significant difference between the two groups before treatment (P> 0.05). After treatment, the concentrations of PCT and CRP in both groups decreased significantly (P <0.05), and the scores ofAPACHEⅡscore and SOFA at 24h, 48h and 168h after treatment decreased significantly (P <0.05). The decreasing degree of each index in the treatment group at each time point (P <0.05). However, there was no significant difference in 28-day mortality between the two groups. CONCLUSIONS: Small doses of hydrocortisone sodium succinate can reduce inflammation in patients with severe sepsis and have some value in improving prognosis.