专业化团队在连续血液净化治疗儿童脓毒性休克中的实践与效果

The effect of specialized team in the treatment of septic shock in children with continuoas blood purification

目的探讨专业化连续血液净化团队(specialized continuous blood purification team,SCT)在连续血液净化(continuous blood purification,CBP)治疗儿童脓毒性休克中的实践与效果。方法回顾性分析2012年1月至2019年6月我院重症医学科收治的68例需行CBP治疗的脓毒性休克患儿的临床资料。以2017年1月1日组建SCT为界,根据CBP是否由SCT实施分为对照组(SCT组建前)和观察组(SCT组建后),比较两组患儿的CBP实施率、CBP上机需要时间、CBP相关不良事件发生率及预后。结果两组患儿的性别、年龄、小儿危重病例评分等基线资料的比较差异无统计学意义(P>0.05)。观察组的CBP实施率高于对照组(96.7%比73.7%,P<0.05),上机需要时间短于对照组[(1.93±0.65)h比(6.25±2.38)h,P<0.01],CBP相关不良事件总发生率低于对照组(18.7%比66.2%,P<0.01),28 d存活率高于对照组(83.3%比60.5%,P<0.05)。结论 SCT能够明显提高脓毒性休克患儿CBP治疗的实施率和效率,减少CBP相关不良事件发生率,提高存活率。

Objective To investigate the effect of specialized continuous blood purification team(SCT)in the treatment of septic shock in children.MethodsThe clinical data of 68 children with septicshock treated with continuous blood purification(CBP)from January 2012 to June 2019 were retrospectivelyanalyzed.Choosing the date of SCT established(January 1,2017)as the bound,the children were divided intothe control group(before the establishment of SCT)and the observation group(after the establishment ofSCT)according to whether the CBP was implemented by SCT.The CBP implementation rate,CBP time toget on the machine,the incidence of CBP-related adverse events and the prognosis of the two groups werecompared.Results There were no significant differences between two groups about baseline data such asgender,age and pediatric critical illness score(P>0.05).The CBP implementation rate of the observationgroup was higher than that in control group(96.7%vs.73.7%,P<0.05),and the CBP time to get on themachine was shorter than that in control group[(1.93±0.65)h vs.(6.25±2.38)h,P<0.01].The overallincidence of CBP-related adverse events was lower than that in control group(18.7%vs.66.2%,P<0.01),and the 28 d survival was higher than that in control group(83.3%vs.60.5%,P<0.05).ConclusionSCT can significantly improve the implementation rate and efficiency of CBP treatment in children with septicshock,reducing the incidence of CBP-related adverse events,and improving the survival rate.