重症监护病房脓毒症患儿预后及其影响因素  

Prognosis of children with sepsis in PICU and its influencing factors

作　　者：李雨铮[1] LI Yu-zheng(The Second Departmentof Respiration, Shenzhen Children＇s Hospital, Shenzhen 518026, Guangdong, CHINA)

机构地区：[1]深圳市儿童医院呼吸二科,广东深圳518026

出　　处：《海南医学》2018年第13期1879-1881,共3页Hainan Medical Journal

基　　金：2016年广东省深圳市卫生计生系统科研项目(编号:201606035)

摘　　要：目的探讨重症监护病房脓毒症患儿预后的影响因素。方法收集2013年1月至2016年12月在深圳市儿童医院儿童重症监护病房住院的164例脓毒症患儿的临床资料,采用多因素Cox比例风险回归分析影响患儿预后的危险因素。结果 164例患儿中死亡39例(23.8%)。单因素分析结果显示,死亡患儿的血小板计数、平均动脉压、PCIS分、血清白蛋白、24 h尿量明显低于存活患儿,休克和尿量感染发生率明显高于存活患儿,累及器官明显多于存活患儿,机械通气时间明显比存活患儿长,差异均有统计学意义(P<0.05);Logistic回归分析结果显示,MODS、休克、PCIS评分、血小板计数、24 h尿量和血清白蛋白与脓毒症患儿死亡密切相关(P<0.05)。结论 MODS、休克、PCIS评分、血小板计数、24 h尿量和血清白蛋白是导致脓毒症死亡的相关危险因素。Objective To investigate the prognosis in children with sepsis in Pediatric Intensive Care Unit（PICU） and its influencing factor. Methods The clinical data from 164 children with sepsis admitted to PICU in Shenzhen Children＇s Hospital from January 2013 to December 2016 were retrospectively analyzed. The risk factors influencing prognosis were analyzed by Cox proportional hazards regression. Results The mortality was 23.8%（39/164）. Single factor analysis showed that, compared with children who survived, children who were died had significantly lower platelet count, lower mean arterial pressure, lower pediatric critical illness score（PCIS）, lower serum albumin, and lower24 h urine volume, significantly higher incidence of shock and urine volume infection, significantly more cases of multiple organ dysfunction syndrome（MODS）, and significantly longer time of mechanical ventilation（P〈0.05）. Logistic regression analysis showed that MODS, shock, PCIS score, platelet count, 24 h urine volume and serum albumin were closely related to the death of children with sepsis（P〈0.05）. Conclusion MODS, shock, PCIS, platelet count, 24 h urine volume, and the serum albumin are the associated risk factors leading to sepsis death.

关 键 词：脓毒症患儿 重症监护室 预后 影响因素 

分 类 号：R726[医药卫生—儿科]