Abstract:Objective: To study the curative effect of norepinephrine combined with milrinone in treating children with septic shock and the effects on serum levels of α-hydroxybutyrate dehydrogenase (HBDH), procalcitonin (PCT), hs-CRP.Methods: 100 children with septic shock admitted to our hospital from May 2017 to May 2019 were selected for the study, and were divided into the observation group (n=51) and the control group (n=49) by the random number table method.The control group was treated with norepinephrine, and the observation group was treated with norepinephrine and milrinone.The clinical effectiveness, serum α - HBDH, PCT, hs CRP, PaCO2, pH, acute physiological and chronic health status scoring system II (APACHE II), sequential organ failure assessment (SOFA), admission time to intensive care unit (ICU) and 28-day mortality were compared between the two groups.Results: After treatment, the total effective rate of the observation group was 96.08%, significantly higher than that of the control group (79.59%) (P<0.05).After treatment, the serum levels of α- HBDH, PCT and hs-CRP in both groups were improved, and the serum levels of α- HBDH, PCT and hs-crp in the observation group were significantly lower than those in the control group (P<0.05).Before treatment, there was no significant difference in blood gas level between the two groups.After treatment, the blood gas indexes of the two groups were improved, and the PaCO2 and pH levels of the observation group were significantly lower than those of the control group (P<0.05).After treatment, APACHE Ⅱ, SOFA score level of the two groups are improved, and in the observation group, APACHE Ⅱ, SOFA scores were significantly lower than control group (P<0.05).The ICU admission time, 28d mortality and total mortality of the observation group were significantly lower than those of the control group, with significant differences (P<0.05).Conclusion: Norepinephrine combined with milinone has a significant effect on the serum levels of α- HBDH, PCT and hs-CRP in children with septic shock.
[1] 刘文悦.参麦注射液联合氢化可的松治疗老年脓毒性休克的临床研究[J].现代药物与临床,2019,34(9):2739~2743. [2] 钟隽镌,张静,郑璇儿,等.血乳酸与血清清蛋白比值对新生儿脓毒性休克的早期预测价值[J].中华实用儿科临床杂志,2019,34(18):1386~1389. [3] Annane D , Renault A , Brun-Buisson C , et al. Hydrocortisone plus fludrocortisone for adults with septic shock[J]. New England Journal of Medicine, 2018, 378(9):809. [4] 杨建钢,杨玉彬,刘清华.脓毒性休克患者早期主要炎性因子水平及其临床意义[J].中华危重病急救医学,2019,31(6):680~683. [5] 中华医学会儿科学分会急救学组,中华医学会急诊医学分会儿科学组,中国医师协会儿童重症医师分会.儿童脓毒性休克(感染性休克)诊治专家共识(2015版)[J].中华儿科杂志,2015,22(8):739~743. [6] Florence Riché, Benjamin G. Chousterman, Patrice Valleur,et al. Protracted immune disorders at one year after ICU discharge in patients with septic shock[J]. Critical Care, 2018, 22(1):42. [7] Kell D B, Pretorius E. To what extent are the terminal stages of sepsis, septic shock, systemic inflammatory response syndrome and multiple organ dysfunction syndrome actually driven by a prion/amyloid form of fibrin[J]. 2018, 44(3):224~238. [8] 孙海涛,郝铁,杨卫红,等.激活素-α在脓毒症患者中的表达水平及临床意义[J].安徽医药,2018,22(9):1752~1754. [9] 陈娟,马小安,魏丹.血必净联合胸腺肽α1对重症肺炎合并脓毒症患者血清PCT、hs-CRP的影响及疗效分析[J].国际检验医学杂志,2018,39(1):90~93. [10] 于新桥,张永芳,赵继华,等.米力农联合去甲肾上腺素治疗婴幼儿难治性休克疗效分析[J].儿科药学杂志,2018,24(7):22~24.