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目的评估集束化治疗在ICU实施的依从性及对严重感染和感染性休克患者预后的影响。方法回顾性调查2005年1月—2010年8月宁夏医科大学附属医院ICU收治的149例进行6h、24h集束化治疗严重感染和感染性休克的患者,了解集束化治疗的依从性及对患者28d病死率的影响。结果集束化治疗中早期血清乳酸的监测、EGDT(早期目标化治疗)和血糖控制,依从性偏低,其他各项依从性较好,均在90%以上。6h、24h集束化治疗达标的依从性分别为46.3%和45.2%。6h达标组的患者28d病死率为43.5%,未达标组的患者28d病死率为87.5%,24h达标组的患者28d病死率为45.9%,未达标组的患者28d病死率为78.4%,达标组的患者28d病死率明显比未达标组患者的28d病死率低(P<0.05)。结论集束化治疗可以更好地改善严重感染和感染性休克患者的预后,应提高感染性休克集束化治疗的依从性。
Objective To assess the compliance of cluster therapy in ICU and the prognosis of patients with severe infection and septic shock. Methods A retrospective survey of 149 patients admitted to the ICU of Affiliated Hospital of Ningxia Medical University from January 2005 to August 2010 was conducted for 6 h and 24 h in the treatment of severe infection and septic shock. The compliance of cluster therapy was evaluated. The impact of mortality. Results The monitoring of serum lactic acid in the early stage of cluster therapy, EGDT (early target therapy) and glycemic control, with low compliance, and other compliance were all above 90%. Compliance with the standard of 6 h and 24 h cluster therapy was 46.3% and 45.2% respectively. The 28-day mortality rate was 43.5% in the 6h group and 28.5% in the 28-day group. The 28-day mortality rate was 45.9% in the non-compliance group and 78.4% in the non-compliance group, Of patients 28d mortality was significantly lower than the non-compliance patients 28d mortality (P <0.05). Conclusion Cluster therapy can better improve the prognosis of patients with severe infection and septic shock, and should improve the compliance of the intensive treatment of septic shock.