摘要
目的探索氢化可的松联合氟氢可的松治疗成人感染性休克的有效性和安全性,为临床应用提供参考。方法选取2013年12月-2016年12月在医院诊断为感染性休克的患者进行研究,将纳入的80例患者进行随机分组,试验组40例患者应用氢化可的松联合氟氢可的松,对照组40例患者应用安慰剂,记录两组患者病死率、心脏指数、心率、收缩压、舒张压、不良反应发生率以及患者生存分析的结果。结果试验组患者90d和180d病死率分别为15.0%、25.0%,均低于对照组患者的25.0%、37.5%(P<0.05);试验组患者心功能改善效果均优于对照组(P<0.05);1年后试验组患者生存率为55.3%,高于对照组患者的40.2%(P<0.05);试验组高血糖不良反应发生高于对照组(P<0.05)。结论氢化可的松联合氟氢可的松治疗成人感染性休克可以有效降低患者病死率,但会导致患者高血糖风险增高。
OBJECTIVE To explore the efficacy and safety of hydrocortisone in combination with hydrofluorocortisone in treatment of septic shock in adults,and to provide reference for clinical application.METHODS A study was conducted on patients diagnosed with septic shock in our hospital from Dec.2013 to Dec.2016.80 patients were enrolled and randomized into the experimental group and the control group.The 40 patients in the experimental group were treated with hydrocortisone and hydrofluorocortisone,whereas the other 40 patients in the control group received placebo.Mortality,heart index,heart rate,systolic blood pressure,diastolic blood pressure,incidence of adverse reactions,and survival analysis results were recorded for both groups.RESULTS Compared with the control group,patients in the experimental group had a 90-day mortality rate of 15.0%and a 180-day mortality rate of 25.0%,significantly lower than those of the control group(25.0% and 37.5%,respectively)(P<0.05).The improvement of cardiac function in septic shock patients of the experimental group was more significant than in the control group(P<0.05).The survival rate after 1 year was 55.3%in the experimental group,significantly higher than that in the control group(40.2%)(P<0.05).In terms of adverse reactions,the risk of hyperglycemia in the experimental group was significantly higher(P<0.05).CONCLUSION Treatment with hydrocortisone in combination with hydrofluorocortisone can effectively reduce the mortality rate of adult patients with septic shock,but it can lead to an increased risk of hyperglycemia.
作者
陈文武
王鑫
饶文明
易敏
CHEN Wen-wu;WANG Xin;RAO Wen-ruing;YI Min(Kaizhou District People's Hospital of Chongqing City,Chongqing 405400,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第23期3540-3543,共4页
Chinese Journal of Nosocomiology
关键词
氢化可的松
氟氢可的松
感染性休克
随机对照试验
Hydrocortisone
Hydrofluorocortisone
Septic shock
Randomized controlled trials
