Effect of Early Continuous Blood Purification Assisted with Hydrocortisone in the Treatment of Severe Sepsis in Children
Objective:To study the effect of early continuous blood purification(CBP)combined with hydrocortisone on severe sepsis in children.Methods:A total of 102 children with severe sepsis admitted to our hospital from January 2019 to December 2022 were divided into control group and observation group by random number table method,with 51 children in each group.The control group was treated with hydrocortisone,and the observation group was treated with early CBP combined with hydrocortisone.The clinical efficacy,sequential organ failure assessment(SOFA),pediatric critical illness score(PCIS),acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,serum inflammatory indexes[interleukin-6(IL-6),IL-10,tumor necrosis factor-α(TNF-α)]levels,serum citrullinated histone H3(CitH3),silent signal regulator 1(SIRT1)levels,and 28-day survival rate were compared between the two groups.Results:The total effective rate of the observation group was 92.16%,which was higher than 76.47%of the control group(P<0.05).After 72 hours of treatment,the SOFA and APACHE II scores of the observation group were lower than those of the control group,and the PCIS score was higher than that of the control group(P<0.05).After 72 hours of treatment,the levels of serum IL-6,TNF-α and CitH3 in the observation group were lower than those in the control group,and the levels of IL-10 and SIRT1 were higher than those in the control group(P<0.05).The 28-day survival rate of the observation group was 96.08%,which was higher than 82.35%of the control group(P<0.05).Conclusion:The combination of early CBP and hydrocortisone in the treatment of children with severe sepsis can significantly improve clinical efficacy,improve the imbalance of the pro-inflammatory and anti-inflammatory systems,reduce organ function damage and severity of the condition,and effectively improve prognosis.
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