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目的:评价小剂量糖皮质激素治疗感染性休克患者对血乳酸及内生肌酐清除率的影响,为临床感染性休克的治疗奠定基础。方法:选取2015年10月—2016年6月收治的感染性休克患者128例,采用随机分组法将其分为治疗组和对照组,每组64例;对照组患者给予常规感染休克治疗,如抗感染、纠正酸中毒、补充血容量、保护脏器的生理功能、改善微循环等药物治疗;治疗组患者给予氢化可的松每隔6 h静脉滴注50 mg治疗,比较两组患者用药后的总有效率和对血乳酸及内生肌酐清除率的影响。结果:经过不同的药物治疗方案后,经小剂量糖皮质激素治疗的治疗组患者在不同时间段(1 d、2 d、4 d)各项指标的改善情况显著优于对照组(P<0.05),低钠血症的发生率显著低于对照组(P<0.05),住院时间显著短于对照组(P<0.05)。结论:在临床治疗感染性休克患者的过程中,采用小剂量糖皮质激素治疗可显著改善患者的血乳酸及内生肌酐清除率,并减少低钠血症的发生,加速患者康复。
Objective: To evaluate the effect of low dose glucocorticoid on the clearance of serum lactate and endogenous creatinine in septic shock patients and lay the foundation for the treatment of septic shock. Methods: Seventy-two patients with septic shock were selected from October 2015 to June 2016. The patients were divided into treatment group and control group by randomization, with 64 cases in each group. The patients in control group were given conventional infection treatment, Anti-infective, correct acidosis, blood volume, protect the physiological function of organs, improve microcirculation and other drug treatment; treatment group patients given hydrocortisone intravenously every 6 h 50 mg treatment, compared two groups of patients after treatment The total effective rate and the effect on the blood lactate and endogenous creatinine clearance rate. Results: After different medication regimens, the improvement of various indexes of the treatment group treated with low dose glucocorticoid at different time points (1 d, 2 d, 4 d) was significantly better than that of the control group (P <0.05 ), The incidence of hyponatremia was significantly lower than that of the control group (P <0.05), and the length of hospital stay was significantly shorter than that of the control group (P <0.05). Conclusion: In the clinical treatment of patients with septic shock, the use of low-dose glucocorticoid therapy can significantly improve the patient’s blood lactate and endogenous creatinine clearance, and reduce the incidence of hyponatremia and accelerate patient rehabilitation.