摘要
目的评价集束化诊疗管理策略对G6PD缺乏急性感染患儿的疗效。方法纳入2014年6月至2022年12月入住广西壮族自治区妇幼保健院重症医学科的160例G6PD缺乏急性感染重症患儿。2018年1月至2022年12月开展集束化预防策略诊疗的80例患儿为观察组,2014年7月至2017年12月未开展集束化预防策略诊疗的80例患儿为对照组。两组患儿在入科时及24h后分别检测血清IL-6和CRP水平,观察组在IL-6和CRP增高2倍时给予小剂量皮质激素、乌司他丁和谷胱甘肽。比较两组炎症指标变化、脓毒症及其并发症发生率、预后、住PICU时间及费用。结果两组入科时血清IL-6和CRP水平无显著差异。集束化预防策略诊疗24h后,观察组血清IL-6和CRP水平显著低于对照组(P<0.05)。观察组脓毒症(68.75%vs.82.50%)、脓毒性休克(47.50%vs.63.75%)、MODS(57.50%vs.73.75%)发生率及未愈死亡率(7.50%vs.18.75%)显著低于对照组,治愈好转率显著高于对照组(92.50%vs.81.25%)(P<0.05)。观察组住PICU时间(6.11±5.06dvs.7.98±6.55d)和住院费用(31908.57±11203.92元vs.35319.33±10312.63元)均显著低于对照组(P<0.05)。结论集束化诊疗管理策略能有效降低G6PD缺乏急性感染重症患儿的炎症反应,减少脓毒症及其并发症的发生,改善预后,缩短住院时间及降低治疗费用,值得在临床推广应用。
Objective To evaluate the efficacy of bundled management strategies in children with acute infections and G6PD deficiency.Methods The clinical data of 120 uremia patients who received Qualcomm hemodialysis in our hospital from October 2022 to October 2023 were collected and analyzed retrospectively.Logistic regression was used to analyze the independent risk factors of CRBSI in uremic Qualcomm hemodialysis patients,and the ROC curve was drawn to evaluate the prediction effect of the model.Results There were no significant differences in serum IL-6 and CRP levels at admission between the two groups.After 24 hours of bundled preventive strategies,the observation group had significantly lower serum IL-6 and CRP levels compared to the control group(P<0.05).The incidence rates of sepsis(68.75%vs.82.50%),septic shock(47.50%vs.63.75%),MODS(57.50%vs.73.75%),and mortality rate(7.50%vs.18.75%)were significantly lower in the observation group,while the cure and improvement rate was significantly higher(92.50%vs.81.25%)compared to the control group(P<0.05).The observation group also had a significantly shorter PICU stay(6.11±5.06 daysvs.7.98±6.55 days)and lower hospitalization costs(31908.57±11203.92 RMBvs.35319.33±10312.63 RMB)compared to the control group(P<0.05).Conclusions Bundled management strategies effectively reduce the inflammatory response in critically ill children with G6PD deficiency and acute infections,decrease the incidence of sepsis and its complications,improve prognosis,shorten hospitalization time,and reduce treatment costs.These strategies are worthy of clinical promotion and application.
作者
韦海娟
郑劼
唐育鹏
韦蓉
莫武桂
Wei Haijuan;Zheng Jie;Tang Yupeng;Wei Rong;Mo Wugui(Department of Intensive Care Medicine,Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital,Nanning,China)
基金
广西医疗卫生适宜技术与开发课题(项目编号:S201405-04)
广西儿科疾病临床医学研究中心项目(项目编号:桂科AD22035121)
作者简介
通信作者:莫武桂,E-mail:mwg188@163.com.
