脓毒性休克早期胃肠黏膜pH变化与其预后相关性研究

Study on the relationship between the changes of gastric intramucosal pH levels and the prognosis of early septic shock

目的:探讨脓毒性休克早期胃肠黏膜pH变化与其预后相关性。方法:脓毒性休克患儿44例根据转归不同分为3组:存活组28例;休克死亡组12例(于入院24h内死亡,死亡原因为不可逆性休克);多器官功能障碍综合征死亡组4例(治疗24h以上,死亡原因为多脏器功能衰竭)。采用胃管法监测其胃肠黏膜pH变化,同时进行生命体征监测和小儿危重病例评分,对其预后相关因素进行分析。结果:存活组与死亡组比较,初次胃肠黏膜pH变化差异有统计学意义(P<0.01),经治疗存活组胃肠黏膜pH明显升高,治疗前、后差异有统计学意义(P<0.05),而死亡组治疗前、后差异无统计学意义(P>0.05)。结论:胃肠黏膜pH变化可直接反映脓毒性休克严重程度,指导临床进行早期干预治疗并改善预后。

Objective To explore the relationship between the changes of gastric intramucosal pH levels and the prognosis of early septic shock. Methods Forty four children with early septic shock were divided into survival group（n= 28）, septic shock death group（n= 12, the main death cause for those who died within 24 hours was irreversible septic shock ） and MODS death group （n=4, the main death cause for those who died after 24 hours was MODS）. The gastric intramucosal pH levels and clinical features, PRISM and PCIS were monitored dynamically. Results The gastric intramucosal pH level in the survival group was higher than that in death group（P〈0.01）, and obviously increased after treatment（P〈0.05）. There was no statistic difference in death group before and after treatment （P〈0.05）. Conclusion The changes of gastric intramucosal pH levels can reflect the degree of septic shock. To monitor dynamically the changes can guide the early intervention and improve the prognosis.