对败血症疗效的临床观察:一项前瞻性研究

Mir Mansoor Sultan, Adeeba Younus, Durre Shahwar Fatima, Faria Mushtaq, Salma Tasneem
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引用次数: 0

摘要

目的研究各种治疗方法的安全性和有效性,并确定严重败血症治疗的趋势和差异,包括抗生素的使用和支持性护理。研究与严重脓毒症患者预后改善或恶化相关的因素,如患者人口统计学特征、合并症或治疗时机。设计:对特伦甘纳邦海得拉巴市杜鲁-舍瓦公主儿童综合医院的所有住院和门诊病人进行为期 6 个月的医院前瞻性研究。研究方法为本研究设计了数据收集表和患者同意书。它包括研究对象的数据信息,如人口统计学、病史和用药史、实验室检查、诊断、目前的处方药和进展表。研究人员收集相关数据并记录在数据收集表中。根据纳入标准和排除标准选择处方。获得的数据经过整理,并使用适当的统计测试进行分析。定量变量采用描述性研究(百分比、平均值、标准差、观察数)进行总结。使用 spss 和成对 t 检验、图表、饼图和条形图对数据进行统计分析。结果 本次前瞻性研究共纳入 115 名患者,其中 60% 的患者对培养敏感。结果发现美罗培南是最有效的抗生素。对治疗效果的分析表明,在多个参数方面都取得了显著成果。干预对降低收缩压有明显效果,但对舒张压的影响不大。在红细胞沉降率(ESR)方面,治疗后的红细胞沉降率大幅下降,并具有统计学意义。值得注意的是,动脉血气(ABG)水平在治疗前后有很大差异,P 值低于 0.05,表明拒绝接受零假设。此外,治疗还与白细胞总数的显著增加有关,这体现在正的平均差异和完全高于零的 95% 置信区间。这些发现强调了治疗对各种生理指标的不同影响。结论 前瞻性脓毒症治疗研究能够细致入微地把握真实世界的有效性,将对照实验与临床现实联系起来。尽管存在偏差,但它们有助于制定循证策略,承认临床的复杂性。这种实用的方法以适应性强、以患者为中心的方法为医护人员提供指导。对严格统计方法的强调增强了理解力。将观察数据与实验数据相结合,丰富了我们对败血症管理的理解。总之,这些研究形成了有效治疗的整体方法。
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CLINICAL OBSERVATION OF TREATMENT EFFICACY IN SEPSIS: A PROSPECTIVE STUDY
Objective: To examine the safety and efficacy associated with various treatment approaches and to identify trends and variations in the management of severe sepsis, including the usage of antibiotics, and supportive care. To examine factors associated with improved or worsened outcomes in severe sepsis cases, such as patient demographics, comorbidities, or timing of treatment. Design: A hospital-based prospective study was done on all inpatients and outpatients in Princess DurruShehvar Childrens & General Hospital, Hyderabad, Telangana for 6 months. Methods: The data collection form and patient consent form were designed for this study. It comprises information regarding the study subjects data such as demographics, medical and medication history, laboratory investigations, diagnosis, present prescribed medication, and progress chart. Investigators collected the relevant data and recorded it in data collection form. The prescription will be selected based on inclusion criteria and exclusion criteria. The data obtained was compiled and analysed using appropriate statistical tests. Quantitative variables were summarized using descriptive studies (percentages, mean, standard deviation, number of observations). The data was statistically analyzed using spss and pair t test, graphs, pie diagrams, and bar graphs. Results A total of 115 patients were included in this prospective study and 60% of them show culture sensitivity. Meropenem was found to be the most potent antibiotic. The analysis of the treatments impact reveals noteworthy outcomes across multiple parameters. The intervention demonstrates a significant effect in reducing systolic blood pressure, although no major influence on diastolic blood pressure is observed. Regarding erythrocyte sedimentation rate (ESR), a substantial and statistically significant decrease is indicated post-treatment. Notably, arterial blood gas (ABG) levels exhibit a considerable difference pre- and post-treatment, with a p-value below 0.05, suggesting a rejection of the null hypothesis. Additionally, the treatment is associated with a significant increase in total leukocyte counts, as evidenced by the positive mean difference and a 95% confidence interval entirely above zero. These findings underscore the diverse impacts of the treatment on various physiological markers. Conclusion Prospective sepsis treatment studies offer a nuanced grasp of real-world effectiveness, linking controlled experiments to clinical reality. Despite biases, they contribute to evidence-based strategies, acknowledging clinical complexities. This practical approach guides healthcare professionals with adaptable, patient-centered methods. Emphasis on rigorous statistical methodologies enhances comprehension. Integrating observational and experimental data enriches our understanding of sepsis management. Overall, these studies shape holistic approaches for effective treatment.
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