不同医院感染性休克集束化治疗依从性的比较

目的:比较不同医院对感染性休克集束化治疗的依从性,探讨对感染性休克实施临床路径的管理的必要性。方法:采用回顾性队列研究的方法,比较不同地区二甲医院(对照组)和三甲医院(试验组)对感染性休克集束化治疗的依从性。结果:试验组2hCVP、2hScvO2监测率、lh抗生素使用依从性较对照组明显提高(P<0.01/<0.05);试验组EGDT、Hct、限制性气道压、血糖控制依从性均较对照组高,(P<0.05或P<0.01);试验组机械通气时间(P<0.01)、ICU住院时间(P<0.01)及28d病死率明显缩短(P<0.05)。结论:不同级别和地区对感染性休克集束化治疗的依从性较低,有必要对感染性休克实施临床路径管理。

Comparison of the Compliance with Medical Care Bundles on Patients with Septic Shock in Different Hospitals

Objective To compare the compliance with medical care bundles on patients with septic shock in different hospitals and to investigate the need of using the clinical path management for patients with septic shock.Method:Use the method of Retrospective cohort study and compare the compliance with medical care bundles on patients with septic shock in control group(second A hospital) and test group(tertiary A hospital).Result:Compared with control group(second A hospital),the rates of compliance with 6-hour care bundle for sepsis in test group(tertiary A hospital) were higher respectively by early goal-directed resuscitation(EGDT)、HCT、plateau pressure、blood glucose control、monitoring of CVP and ScvO2 within 2 hour、using of antibiotic within 1 hour.At the same time,patients intest group had the shorter duration of mechanical ventilation,shorter stay in ICU and a lower 28-day mortality rate than patients in contral group.Conclusions:The compliances with medical care bundles in patients with septic shock are poor in different hospitals which in different places and hospital grand,it is needed to use the clinical path management for the patients with sepsis shock.