小剂量氢化可的松联合去甲肾上腺素对脓毒性休克患者血流动力学指标的影响研究

Study on the Influence of Low Dose Hydrocortisone and Norepinephrine on Hemodynamics in Septic Shock

目的 分析脓毒性休克患者应用小剂量氢化可的松联合去甲肾上腺素的效果和对血流动力学指标产生的影响。方法 方便选取2023年1—12月漳浦天福医院收治的74例脓毒性休克患者为研究对象,根据不同的治疗方法分为参照组(实施去甲肾上腺素治疗)和观察组(实施小剂量氢化可的松联合去甲肾上腺素治疗),各37例。对比两组的临床相关指标、炎症因子指标、血流动力学指标。结果 观察组休克改善时间为(1.28±0.39)d、重症监护室住院时间为(7.21±2.12)d、总住院时间为(11.21±1.78)d,均短于参照组的(3.31±0.45)d、(10.44±2.89)d、(15.89±3.34)d,差异有统计学意义(t=20.736、5.482、7.522,P均<0.05)。观察组治疗后炎症因子指标水平低于参照组,差异有统计学意义(P<0.05)。观察组治疗后平均动脉压高于参照组,心率和心排血指数均低于参照组,差异有统计学意义(P均<0.05)。结论 脓毒性休克患者应用小剂量氢化可的松联合去甲肾上腺素的效果显著,可以改善血流动力学指标,降低炎症指标。

Objective To analyze the effect of low-dose hydrocortisone combined with noradrenaline and its effect on hemodynamic parameters in patients with septic shock.Methods A total of 74 patients with septic shock admitted to Zhangpu Tianfu Hospital from January to December 2023 were conveniently selected as the research objects.Accord⁃ing to different treatment methods,they were divided into reference group(treated with norepinephrine)and observa⁃tion group(treated with low-dose hydrocortisone combined with norepinephrine),37 cases in each group.The clinical related indexes,inflammatory factor indexes and hemodynamic indexes of the two groups were compared.Results The improvement time of shock in the observation group was(1.28±0.39)d,the inten sive care unit(ICU)hospitalization time was(7.21±2.12)d,and the total hospitalization time was(11.21±1.78)d,which were shorter than those in the ref⁃erence group(3.31±0.45)d,(10.44±2.89)d,(15.89±3.34)d,the differences were statistically significant(t=20.736,5.482,7.522,all P<0.05).The inflammatory factor index level of the observation group was lower than that of the refer⁃ence group after treatment,and the difference was statistically significant(P<0.05).After treatment,the mean arterial pressure in the observation group was higher than that in the reference group,and the heart rate and cardiac output in⁃dex were lower than those in the reference group,the differences were statistically significant(all P<0.05).Conclusion The effect of low-dose hydrocortisone combined with norepinephrine in patients with septic shock is significant,which can improve hemodynamic indexes and reduce inflammatory indexes.