早期补充维生素C联合氢化可的松治疗严重脓毒症的疗效分析

Analysis of the efficacy of early vitamin C supplementation combined with hydrocortisone in treating severe sepsis

目的:探讨早期补充维生素C联合氢化可的松治疗严重脓毒症的疗效分析。方法:研究对象选取本院2019年5月—2020年5月收治的严重脓毒症患者120例,采用随机数字法将其分为对照组(n=60)和观察组(n=60)。所有患者入院后均行常规治疗,在此基础上,对照组采用氢化可的松静脉滴注,1次/6 h;观察组在对照组基础上进行早期补充维生素C干预,从患者进入EICU当天开始进行,将3 g维生素C溶解于5%葡萄糖注射液静脉滴注,1次/6 h,两组均干预3 d。比较两组的血管活性药物使用天数、住急诊重症监护室(EICU)时间、总住院时间以及治疗前后的血清生化指标水平,并比较两组预测病死率、实际病死率、急性肾损伤(AKI)发生率。结果:观察组的活性药物使用天数、住EICU时间、总住院时间均明显少于对照组(P<0.05);治疗前,两组血清丙二醛(MDA)、降钙素原(PCT)和超氧化物歧化酶(SOD)水平比较,差异无统计学意义(P>0.05),治疗后,两组的MDA和PCT水平均下降,SOD水平明显升高,其中观察组的上升和下降幅度均高于对照组(P<0.05);观察组的预测病死率、实际病死率和急性肾损伤(AKI)发生率均明显低于对照组(P<0.05)。结论:早期补充维生素C能明显提高氢化可的松治疗严重脓毒症患者疗效,改善其预后,降低病死率,值得在临床推广。

Objective:To explore the effect of early vitamin C supplementation combined with hydrocortisone in treating severe sepsis.Methods:A total of 120 patients with severe sepsis treated in our hospital from May 2019 to May 2020were randomly divided into the control group(n=60)and the observation group(n=60).All patients received conventional treatment after admission.On this basis,the control group was treated with hydrocortisone once every 6 hours.From the day the patient entered the emergency intensive care unit(EICU),the observation group received early vitamin C supplementation(3 g vitamin C dissolved in 5%glucose injection)once every 6 hours based on the control group.Both groups intervened for three days.The days of vasoactive drugs used,the time of living in EICU,the total length of hospital stay,and the level of serum biochemical indexes before and after treatment were compared between the two groups.The predicted mortality,actual mortality,and the incidence of acute renal injury(AKI)were compared between the two groups.Results:The days of active drug use,EICU stay,and total hospital stay in the observation group were significantly shorter than those in the control group(P<0.05).Before treatment,there was no significant difference in the levels of malondialdehyde(MDA),procalcitonin(PCT),and superoxide dismutase(SOD)between the two groups(P>0.05).After treatment,serum MDA and PCT levels in both groups decreased,while the levels of SOD increased significantly.The increase and decrease in the observation group were higher than in the control group(P<0.05).The predicted mortality,actual mortality,and the incidence of acute renal injury(AKI)in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Early vitamin C supplementation can significantly improve the efficacy of hydrocortisone in treating severe sepsis,improve the prognosis,and reduce mortality,which is worthy of clinical promotion.