集束化治疗对严重脓毒症患者预后的前瞻性随机对照研究

Effects of sepsis bundles on prognosis of patients with severe sepsis: a prospective, randomized, controlled Trial

目的:研究集束化治疗对综合ICU严重脓毒症患者预后的影响。方法:选2007年10月至2009年12月收住ICU的18岁以上严重脓毒症患者,随机分配入集束化治疗组和对照组,观察两组患者序贯器官衰竭估计(SOFA)评分的变化及血管活性药物使用时间、28d机械通气时间、ICU停留时间和28d病死率。结果:集束化治疗组入选后3d和7dSOFA评分均明显低于对照组同期(P<0.05);集束化治疗组血管活性药物使用时间、28d内机械通气时间、ICU停留时间均短于对照组,28d病死率绝对值下降20%,其中血管活性药物使用时间和ICU停留时间缩短具有统计学差异(P<0.05)。结论:集束化治疗可以明显改善严重脓毒症患者的预后。

Objective To study the effects of sepsis bundles on prognosis of patients with severe sepsis. Methods Patients with severe sepsis, over 18 years old, at the ICU from October 2007 to December 2009,were randomly divided into sepsis bundle group and control group. The SOFA score, the vasoactive agent application times, the mechanical ventilation times at day 28, length of ICU stay, and 28-day mortality of the two groups were recorded. Results As compared to control group, SOFA score at day 3 and 7, the vasoactive agent application times, the mechanical ventilation times at day 28, and length of ICU stay were decreased in the sepsis bundle group （P 〈 0.05）. And the patients in the sepsis bundle group had a lower 28-day mortality rate than those did in control group （21.9% vs. 41.9%）. Conclusion Application of the sepsis bundles could improve the prognosis of patients with severe sepsis.