早期综合加强治疗策略抢救小儿脓毒症器官功能不全的临床研究

目的探讨脓毒症器官功能不全患儿的早期综合加强治疗策略。方法对2006年3月至2008年7月期间的39例脓毒症器官功能不全患儿，根据其临床表现，评估其所处的全身炎症反应综合征／代偿性抗炎症反应综合征（SIRS／CARS）平衡状态，按个体化原则采用不同强度的扩容、血管活性药物、抗感染、糖皮质激素、呼吸支持、大剂量静脉免疫球蛋白、大剂量血浆、小剂量肝素、细胞因子拮抗剂、中医中药等综合治疗。并与2004年6月至2006年2月期间收治的30例同类患儿应用常规治疗方法结果进行比较。结果观察组39例存活35例，死亡4例，死亡率10．25％；对照组30例存活21例，死亡9例，死亡率30．00％。两组比较X2=4．32，P〈0．05。结论针对脓毒症复杂的病理生理和免疫失衡，运用早期综合加强治疗策略，及时调整患儿的SIRS／CARS失衡可显著提高抢救成功率。

Clinical study of early comprehensive and intensive therapy on the sepsis with organ dysfunction in Children

Objective To explore the strategy of early comprehensive and intensive therapy on the sepsis with organ dysfunction in children.Methods From Mar.2006 to July 2008,the 39 patients who were diagnosed sepsis with organ dysfunction,according to their clinical manifestation,were evaluated the balanced condition of systemic inflammatory response syndrome/compensatory anti-inflammatory response syndrome(SIRS/CARS).Then the different intensity of combined therapy such as fluid expansion,vasoactive agent,anti-infect...