糖皮质激素用于严重脓毒血症及脓毒性休克患者抢救的临床价值

Clinical value of corticosteroids for rescue of patients with severe sepsis and septic shock

目的为提高临床治愈率,了解糖皮质激素在严重脓毒血症及脓毒性休克患者抢救治疗中的应用价值。方法选择2009年1月-2010年12月ICU 51例接受抢救的严重脓毒血症及脓毒性休克患者,单盲随机将其中的32例分为试验组,余者分为对照组。结果试验组患者休克治愈率为68.8%,升压药停用率为73.7%,休克治愈率和升压药停用率显著高于对照组,病死率为26.3%显著低于对照组,差异均有统计学意义(均P<0.05);试验组患者升压药停用时间、休克逆转时间及机械通气停用时间显著短于对照组,差异有统计学意义(P<0.05)。结论对于脓毒血症及脓毒性休克的患者,适量应用糖皮质激素,可提高休克治愈率,降低死亡率。

OBJECTIVE To improve the clinical cure rate and understand the application value of corticosteroids in treatment of patients with severe sepsis and septic shock. METHODS A total of 51 cases of patients with severe sepsis and septic shock,which were rescued in our department between Jan 2009 and Dec 2010 were selected.32 cases of patients were single-blind randomly divided into experimental group,and the remainder into control group. RESULTS The cure rate of shock of experimental groups of patients was 68.8%,and their discontinuation rate of pressor drugs was 73.7%.The cure rate of shock of and the discontinuation rate of experimental groups of patients were significantly higher than that of control groups of patients（P〈0.05）,while fatality rate of experimental groups of patients was 26.3%,significantly lower than in control group（P〈0.05）.The discontinuation time of pressor drugs,the reverse time of shock and the discontinuation time mechanical ventilation were significantly shorter than that in control group（P〈0.05）. CONCLUSION For patients with severe sepsis and septic shock,compatibly using corticosteroids can improve the cure rate of shock,and reduce the fatality rate.