集束治疗依从性在ICU感染性休克患者治疗中的调查及对预后的影响

The study of the compliance of cluster therapy in the patients with septic shock in ICU and its effects on prognosis

目的 了解ICU感染性休克患者的集束治疗依从性,探讨其对患者预后的影响。方法 选择2014年1月-2016年3月的80例ICU感染性休克患者,根据复苏达标与否,将其分为达标组与未达标组,比较两组的预后情况。结果 6 h集束治疗中有3项达标率均在90%以上,完成早期目标化治疗的达标率仅65.00%;24 h集束治疗中的达标率总体较低,仅控制呼吸机吸气平台压不超过30 cm H2O的达标率超过90%。80例的总达标率为63.75%。达标组治疗后72 h血乳酸水平、ICU天数及28 d病死率明显低于未达标组（P〈0.05）。结论 ICU感染性休克患者集束治疗的个别单项达标率较低,预后较差,应加大对医护人员的系统培训,提高对集束治疗的依从性。

Objective To study the compliance of cluster therapy in the patients with septic shock in ICU and discuss its effects on the patients＂ prognosis. Methods A total of 80 patients with septic shock in ICU from January 2014 to March 2016 were selected, and their single compliance of cluster therapy was reviewed according to recovery standards or not. Thd patients were assigned into the compliance group and the non-compliance group and the prognosis of two groups were compared. Results During the 6-hour cluster therapy, the compliance rates of 3 indices were over 90% while the compliance rate of early target therapy was only 65.00%. During the 24-hour cluster therapy, only the com- pliance rate of keeping the pressure of ventilator suction platform not exceeding 30 cmH20 reached over 90%, yet the other compliance rates in the cluster therapy were generally lower. On the whole, the total compliance rate of the 80 patients was 63.75%. The blood lactic acid level 72 hours after the treatment, days in ICU and 28-day mortality rate in the compliance group were significantly lower than those in the non-compliance group（P〈0.05）. Conclusion The single compliance rate of the cluster therapy for septic shock patients in ICU is low and the prognosis is poor. The systemic training on health care professionals should be enhanced so as to improve the compliance of the cluster therapy.