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目的:探讨脓毒性休克早期胃肠黏膜pH变化与其预后相关性。方法:脓毒性休克患儿44例根据转归不同分为3组:存活组28例;休克死亡组12例(于入院24h内死亡,死亡原因为不可逆性休克);多器官功能障碍综合征死亡组4例(治疗24h以上,死亡原因为多脏器功能衰竭)。采用胃管法监测其胃肠黏膜pH变化,同时进行生命体征监测和小儿危重病例评分,对其预后相关因素进行分析。结果:存活组与死亡组比较,初次胃肠黏膜pH变化差异有统计学意义(P<0.01),经治疗存活组胃肠黏膜pH明显升高,治疗前、后差异有统计学意义(P<0.05),而死亡组治疗前、后差异无统计学意义(P>0.05)。结论:胃肠黏膜pH变化可直接反映脓毒性休克严重程度,指导临床进行早期干预治疗并改善预后。
Objective: To investigate the relationship between the early gastric mucosal pH change and its prognosis in septic shock. Methods: Forty-four children with septic shock were divided into three groups according to the outcome: survivorship group (n = 28), shock death group (n = 12) (died within 24h after admission and the cause of death was irreversible shock), multiple organ dysfunction syndrome Group 4 cases (more than 24h treatment, the cause of death for multiple organ failure). Gastric tube method was used to monitor the changes of gastrointestinal mucosal pH, and vital signs and pediatric critical cases were scored. The prognostic factors were analyzed. Results: Compared with the death group, there was significant difference in the pH value of the initial gastrointestinal mucosa between the survival group and the death group (P <0.01). The pH value of the gastrointestinal mucosa increased significantly in the survival group after treatment, with significant difference before and after treatment (P < 0.05), while there was no significant difference in death group before and after treatment (P> 0.05). Conclusion: The change of gastrointestinal mucosal pH can directly reflect the severity of septic shock, guide the clinical treatment of early intervention and improve the prognosis.