| 刘 幸,张 越,王 敏,张 蕾,王婉娟,刘晓庆.小剂量糖皮质激素联合持续性血液净化治疗儿童严重脓毒症的效果及安全性研究[J].,2024,(4):768-771 |
| 小剂量糖皮质激素联合持续性血液净化治疗儿童严重脓毒症的效果及安全性研究 |
| Efficacy and Safety of Low Dose Glucocorticoid Combined with Continuous Blood Purification in the Treatment of Severe Sepsis in Children |
| 投稿时间：2023-07-06 修订日期：2023-07-25 |
| DOI：10.13241/j.cnki.pmb.2024.04.033 |
| 中文关键词: 儿童 严重脓毒症 糖皮质激素 持续性血液净化 炎症反应 |
| 英文关键词: Children Severe sepsis Glucocorticoid Continuous blood purification Inflammatory response |
| 基金项目:陕西省科技厅一般项目-青年项目（2022JQ-853） |
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| 中文摘要: |
| 摘要 目的：分析小剂量糖皮质激素联合持续性血液净化治疗儿童严重脓毒症的效果及安全性。方法：选择自2021年1月至2023年1月接诊的102例儿童严重脓毒症患儿作为研究对象，随机分为对照组和观察组，各51例；对照组予以经典治疗方案，观察组在对照组的基础上，予以小剂量糖皮质激素联合持续性血液净化治疗；记录两组治疗后各项信息，比较两组治疗前后外周血乳酸、中心静脉血氧饱和度（ScvO2）、血清炎症指标、PCIS评分、APACHE Ⅱ评分，观察主要并发症发生情况。结果：与对照组相比，观察组机械通气、低血压持续及入住ICU等时间较短，7 d内停升压药率较高（P＜0.05）；两组28 d病死率比较无差异（P＞0.05）；观察组治疗后乳酸、降钙素原（PCT）、肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）水平均较对照组低，ScvO2水平较对照组高（P＜0.05）；观察组治疗后PCIS评分较对照组高，APACHE Ⅱ评分较对照组低（P＜0.05）；观察组主要并发症发生率低于对照组（P＜0.05）。结论：小剂量糖皮质激素联合持续性血液净化治疗有利于儿童严重脓毒症患儿病情转归，减少主要并发症发生，可能与阻断炎症反应有关，值得进一步研究应用。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the efficacy and safety of low dose glucocorticoid combined with continuous blood purification in the treatment of severe sepsis in children. Methods: A total of 102 children with severe sepsis from January 2021 to January 2023 were selected as research objects and randomly divided into matched group and observation group, with 51 cases in each group. The matched group was given classical treatment, and the observation group was given low-dose glucocorticoid combined with continuous blood purification on the basis of the matched group. The information of the two groups after treatment was recorded. The peripheral blood lactic acid, central venous oxygen saturation (ScvO2), serum inflammation index, PCIS score, APACHE Ⅱ score before and after treatment were compared between the two groups, and the occurrence of main complications was observed. Results: Compared with the matched group, mechanical ventilation, hypotension and admission to the ICU were shorter, and the rate of stopping the booster within 7 d was higher (P<0.05). There was no difference in 28 d mortality between the two groups(P>0.05). After treatment, the levels of lactic acid, procalcitonin (PCT), tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) in observation group were lower than those in matched group, while the level of ScvO2 was higher than that in matched group(P<0.05). After treatment, PCIS score of observation group was higher than that of matched group, APACHE Ⅱ score was lower than that of matched group(P<0.05). The incidence of main complications in the observation group was lower than matched group(P<0.05). Conclusion: Low-dose glucocorticoid combined with continuous blood purification treatment is conducive to the disease outcome of children with severe sepsis, reduce the occurrence of major complications, and may be related to the blockade of inflammatory response, which deserves further research and application. |
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