脓毒性休克患儿早期不同时机应用抗菌药物效果分析

Effect analysis of different timing of antibiotic therapy in children with septic shock

目的：探讨不同时机应用抗菌药物治疗脓毒性休克患儿的临床效果。方法回顾性分析2010年8月~2013年10月来我院治疗的146例脓毒性休克患儿的临床资料，将患儿按照第1次抗菌药物使用时间分组，观察组73例为入院后1h内接受抗感染治疗的患儿，对照组73例为入院后1~6h接受抗感染治疗的患儿。比较两组各时间段外周血中乳酸、CRP、PCT水平、休克持续时间及病死率。结果①两组入院后24h及入院后72h的乳酸、CRP、PCT水平均明显低于入院时，而入院后72h水平明显低于入院后24h，差异有统计学意义（P＜0.05）。观察组入院后24h的乳酸水平、入院后24h及入院后72h的CRP水平、入院后72h的PCT水平与对照组比较明显较低，差异有统计学意义（P＜0.05）。②观察组休克持续时间与对照组比较明显较短，差异有统计学意义（P＜0.05）。结论采用早期经验性抗感染治疗脓毒性休克患儿能使休克持续时间缩短，发挥抗炎、抗休克作用的时间更早，使抢救成功率提高。

Objective To investigate the clinical effects of the different timing of antibiotic therapy in children with septic shock. Methods Retrospectively analyzed 146 cases of children with septic shock in our hospital from Aug 2010 to Oct 2013,according to the first time of using antimicrobial drug,they were divided into two groups. The observation group （73 cases） were given anti-infective therapy within 1h after admission, the control group （73 cases） were given anti-infective therapy at 1~6h after admission. Compared the lactate, CRP, PCT level on different time, shock duration and mortality of two group. Re-sults ①The lactate, CRP, PCT level of observation group and control group hospitalized after 24h and 72h were significantly lower than the time of admission, but those of 72h after admission were significantly lower than those of 24h after admission, the difference were significant （P＆lt;0.05）. Lactate level after admission 24h, CRP level after admission 24h and 72h, PCT level after admission 72h of observation group were lower than admission group, the differences were significant （P＆lt;0.05）. ②The shock duration of the observation group was significantly shorter than the control group, the difference was significant （P＆lt;0.05）. Conclusion Early empiric anti-infective therapy of children with septic shock can shorten the duration of shock and increase the survival rate of the disease.