脓毒性休克患者早期集束化治疗的依从性调查及影响因素分析

Investigation of compliance and analysis of influencing factors of early cluster therapy in patients with septic shock

目的分析急诊科脓毒性休克患者早期集束化治疗的依从性及影响因素,以期为临床改善患者预后提供依据。方法回顾性分析2020年9月—2021年6月急诊科就诊的89例脓毒性休克患者临床资料,统计患者早期集束化治疗的依从性;采用单因素和多因素Logistic回归,分析患者早期集束化治疗依从性的相关影响因素。结果89例脓毒性休克患者,1 h、3 h、6 h的集束化治疗依从性分别为25.84%(23/89)、62.92%(56/89)、30.34%(27/89)。单因素分析显示,患者的家庭支持、经济条件、医疗费用支付方式、入院体温及接诊医护人员指南知晓率为患者早期集束化治疗依从性的影响因素(P<0.05);多因素分析显示,患者的经济条件、入院体温及接诊医护人员指南知晓率均为患者早期集束化治疗依从性的独立影响因素(P<0.05)。结论急诊科脓毒性休克患者早期集束化治疗的依从性较差,受患者的经济条件、体温及接诊医护人员指南知晓率影响。建议加强医患沟通,并重视对医护人员的临床技能及脓毒症休克管理指南相关知识的培训,以提高早期集束化治疗的依从性。

Objective To investigate the adherence to and influencing factors of early cluster therapy in septic shock patients admitted to the Emergency Department,with the aim of providing clinical evidence for improving patient prognosis.Methods The clinical data of 89 patients with septic shock who were treated in the department of emergency were retrospectively analyzed between September 2020 and June 2021.The compliance rate of patients receiving early cluster therapy was calculated.Univariate and multivariate logistic regression analyses were conducted to identify the factors associated with patient compliance with early cluster therapy.Results Among 89 patients with septic shock,the compliance rates of 1 h cluster therapy,3 h cluster therapy,and 6 h cluster therapy were 25.84%(23/89),62.92%(56/89),and 30.34%(27/89).Univariate analysis showed that family support,economic conditions,payment methods of medical expenses,admission temperature,and awareness rate of medical staff’s guidelines were all influencing factors of early cluster therapy compliance(P<0.05).Multivariate analysis revealed that economic conditions,admission temperature,and medical staff s guideline awareness rate were independent factors influencing early cluster therapy compliance(P<0.05).Conclusions The compliance with early clustertherapy among septic shock patients in the emergency department is suboptimal and influenced by economic status,body temperature,and medical staff guideline awareness.Improving doctor-patient communication and prioritizing clinical skill training for septic shock management guidelines are necessary to enhance adherence to early clustertherapy.