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目的:探讨亚低温治疗对严重脓毒症患儿重要器官功能的保护作用。方法:选择中山市博爱医院儿科2007年1月至2013年9月诊断为感染性休克、严重脓毒症、多器官功能衰竭且住院48 h以上的患儿,共73例,随机分为亚低温治疗组32例和常规对照组41例,对照组给予常规治疗,治疗组在常规治疗基础上加用亚低温治疗(肛温34~36℃),记录并分析两组患儿的体温、心率、谷丙转氨酶(ALT)、谷草转氨酶(AST)、肌酸激酶(CK)、心肌型肌酸激酶同工酶(CK-MB)、血清尿素氮(BUN)、肌酐(Cr)、乳酸、血小板(PLT)、凝血时间(PT)、部分凝血酶原时间(APTT)。结果:治疗后治疗组的心率、CK、CK-MB、AST、ALT水平低于对照组(P<0.05);BUN、Cr、PLT水平及PT、APTT、院内感染率两组患儿比较差异无统计学意义(P>0.05);两组患儿的病死率比较差异无统计学意义(P>0.05),但治疗组死亡病例院内存活时间较对照组长(P<0.05)。结论:亚低温对严重脓毒症患儿的心脏和肝脏功能有一定保护作用。
Objective: To investigate the protective effect of mild hypothermia on the function of vital organs in children with severe sepsis. Methods: A total of 73 children admitted to Pok Oi Hospital of Zhongshan City from January 2007 to September 2013, who were diagnosed as septic shock, severe sepsis and multiple organ failure and hospitalized for more than 48 h, were randomly divided into mild hypothermia 32 cases in the treatment group and 41 cases in the control group. The control group was given routine treatment. The treatment group was treated with mild hypothermia (rectal temperature 34-36 ℃) on the basis of routine treatment. The body temperature, heart rate, (ALT, AST, CK, CK-MB, BUN, Cr, lactate, platelet PLT), clotting time (PT), partial prothrombin time (APTT). Results: After treatment, the levels of CK, CK-MB, AST and ALT in the treatment group were lower than those in the control group (P <0.05). The levels of BUN, Cr and PLT, PT, APTT and nosocomial infection in the treatment group were significantly lower than those in the control group (P> 0.05). There was no significant difference in mortality between the two groups (P> 0.05). However, the survival rate of the patients in the treatment group was longer than that of the control group (P <0.05). Conclusion: Mild hypothermia may play a protective role on heart and liver function in children with severe sepsis.