新生儿感染性休克发生与疾病危重评分和多脏器功能损害的关系研究  

Relationship between septic shock in neonates and critical illness score and multiple organ dysfunction

作　　者：曹献云[1] 李岩[1] 剧松丽 宋菲[1] 徐雁[1] 

机构地区：[1]郑州大学附属医院南阳市中心医院儿科,河南南阳473009

出　　处：《中华医院感染学杂志》2017年第2期425-428,共4页Chinese Journal of Nosocomiology

基　　金：河南省教育厅科学技术研究重点项目(132114712125)

摘　　要：目的探讨新生儿感染性休克发生与疾病危重评分和多脏器功能损害的关系,为临床早期诊断及早预防提供理论依据。方法回顾性分析2010年1月-2015年12月在医院治疗的45例感染性休克患者的临床资料;45例患儿轻度休克(轻度组)10例,中度休克(中度组)28例,重度休克(重度组)7例;比较不同休克程度患儿新生儿疾病危重病例评分、脏器功能损害等情况。结果轻度组与中度组感染性肺炎的发生率较高,显著高于重度组,重度组以败血症的发病率最高,显著高于轻度组与中度组,差异有统计学意义(P<0.05);重度组新生儿疾病危重评分85.7%患儿<70分,显著高于轻度组和中度组,轻度组50.0%患儿评分>90分,显著高于中度组及重度组,差异有统计学意义(P<0.05);轻度组100.0%的患儿1个脏器功能衰竭,中度组53.6%的患儿1个脏器功能衰竭,重度组14.3%的患儿1个脏器功能衰竭,轻度组显著高于中度组及重度组,中度组高于重度组,差异有统计学意义(P<0.05);轻度组无3个及4个脏器衰竭的病例,重度组57.1%的患儿2个脏器衰竭,显著高于轻度组,差异有统计学意义(P<0.05)。结论新生儿感染休克程度重的患儿,新生儿疾病危重病例评分越低,脏器功能损害个数越多。OBJECTIVE To explore the relationship between septic shock in neonates and critical illness score and multiple organ dysfunction so as to provide theoretical basis for clinical diagnosis and prevention in early stage. METHODS The clinical data Of 45 patients with septic shock who were treated in the hospital from Jan 2010 to Dec 2015 were retrospectively analyzed; 10 neonates with mild shock were assigned as the mild group, 28 neonates with moderate shock were set as the moderate group, and 7 neonates with severe shock were assigned as the severe group. The critical illness score and organ dysfunction were observed and compared among the three groups of neonates. RESULTS The incidence of infectious pneumonia was significantly higher in the mild group and the moderate group than in the severe group; the morbidity of sepsis was significantly higher in the severe group than in the mild group and the moderate group（P〈0.05）. The proportion of the neonates whose critical illness score was less than 70 points was 85.7% in the severe group, significantly higher than that in the mild group and the moderate group; the proportion of the neonates whose critical illness score was more than 90 points was 50.0% in the mild group, significantly higher than that in the moderate group and the severe group. The proportion of the neonates who had one organ failure was 100.0% in the mild group, significantly higher than 53.6% in the moderate group and 14.3% in the severe group, which was higher in the moderate group than in the severe group（P〈0.05）. The neonates did not have three or four organs failure in the mild group, the proportion of the neonates who had two organs failure was 57. 1% in the severe group, significantly higher than that in the mild group（P〈0.05）. CONCLUSION As for the neonates with severe septic shock, the lower the critical illness score, the more the organs of dysfunction are.

关 键 词：新生儿疾病危重病例评分 多脏器功能损害 新生儿感染性休克 

分 类 号：R722.1[医药卫生—儿科]