摘要
目的探讨感染性休克患儿死亡危险因素,以期采取针对性措施,降低病患死亡率。方法回顾性调查2003年1月-2011年9月32例感染性休克患儿的临床资料,分析临床特点,研究相关因素,包括年龄、性别、基础疾病、病原菌、临床征象、并发症等变量,采用单因素分析和多因素logistic回归,分析感染性休克死亡相关危险因素。结果 32例患儿中死亡13例,病死率40.63%;细菌学检出病原菌32株,前4位病原菌依次为铜绿假单胞菌、酿脓链球菌、肺炎克雷伯菌及大肠埃希菌,分别占37.49%、15.62%、12.50%和9.38%;单因素分析显示,死亡组与存活组的白细胞计数、血清乳酸值、血糖、血小板计数、多脏器功能失常综合征(MODS)受累脏器数、小儿危重病例评分、抗菌药物应用不当、CRP、白蛋白之间差异有统计学意义(P<0.05);logistic多因素分析显示血清乳酸值、多脏器功能失常综合征(MODS)受累脏器数及抗菌药物应用不当是感染性休克患儿死亡的独立危险因素。结论感染性休克患儿病死率高,乳酸水平升高、合并MODS以及抗菌药物应用不当是影响患儿死亡的危险因素,应针对上述因素制定针对性预防措施。
OBJECTIVE To identify the risk factors for the death of children with septic shock so as to take the targeted inventions to reduce the mortality.METHODS The clinical data of 32 patients with septic shock who hospitalized from Jan 2003 to Sep 2011 were studied retrospectively.From the start of the hospitalization,variables such as age,sex,underlying disease,etiology,clinical signs and complication were included as the research factors,stepwise logistic regression analysis was performed to identify risk factors associated with septic shock.RESULTS Of the 32 cases of children investigated,the mortality was 40.63%.Totally 32 strains of pathogens were isolated,the first four detected bacterial species were Pseudomonas aeruginos（37.49%）,Astreptococcus pyogenes（15.62%）,Klebsiella pneumoniae（12.50%） and Escherichia coli（9.38%）.The univariate analysis showed that the difference in the leukocyte count,serum lactic acid,blood sugar,platelet count,number of dysfunction organs,PCIS,hospitalization time,inapproprate initial antibiotic agent use,CRP or albumin level between the death group and the study group was statistically significant.The multivariate logistic regression analysis indicated that the serum lactic acid,number of dysfunction organs and inappropriate use of antibiotic agents were the independent risk factors for the death of children with septic shock.CONCLUSION The mortality of septic shock is high;the elevated serum lactic acid level,complication of MODS,and inappropriate use of antibiotic agents are the risk factors for the death of the children with septic shock,and the targeted interventions should be formulated according to the risk factors.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第10期2382-2384,共3页
Chinese Journal of Nosocomiology
基金
温州市科技局项目(Y20120057)
关键词
儿科
感染性休克
病死率
危险因素
Pediatrics department
Septic shock
Mortality
Risk factor
