重症肺炎高危因素及预后相关因素的回顾性分析  

Retrospective analysis of high risk factors and prognostic factors in children with severe pneumonia

作　　者：杨明明 卢慧娜[1] 杨璐[1] 陈敏 陈启雄 Yang Mingming;Lu Huina;Yang Lu;Chen Min;Chen Qixiong(Department of Pediatrics,Chongqing Traditional Chinese Medicine Hospital)

机构地区：[1]重庆市中医院儿科,重庆400021

出　　处：《重庆医科大学学报》2020年第6期809-812,共4页Journal of Chongqing Medical University

基　　金：重庆市科技局基础研究资助项目(编号:cstc2019jcyj-msxmX0186)。

摘　　要：目的:回顾性病例对照研究探讨重症肺炎高危因素及重症肺炎预后相关因素,以便于基层医生对重症肺炎早期识别及干预,必要时转诊以降低重症肺炎死亡率。方法:采用回顾性病例对照研究。在2014年1月至2019年1月重庆市中医院儿科确诊重症肺炎患儿164例作为病例组。从同科室、入院日期相近(小于8周)、确诊为轻症肺炎患儿中选取100例患儿为对照组。用logistic回归对2组病例的资料进行统计学分析。用COX风险模型对重症肺炎预后相关因素进行统计学分析。结果:年龄<3个月(OR=5.210,95%CI=1.565~17.364)、农村居住地(OR=2.730,95%CI=1.016~7.331)、基础疾病(OR=5.620,95%CI=2.023~15.696)是发生重症肺炎的独立危险因素。SpO2≤90%(SpO2≤90%vs.SpO2>90%,OR=1.520,95%CI=1.010~2.310)和多系统并发症(单系统vs.多系统,OR=0.660,95%CI=0.445~0.978)是重症肺炎预后不良的风险因素。结论:年龄<3个月、农村地区居住、有基础疾病患儿更易患重症肺炎。SpO2≤90%和多系统并发症是导致重症肺炎预后不良的因素。因此,基层医生应加强对有高危因素的肺炎临床观察,早期识别重症肺炎及早转诊以降低重症肺炎死亡率。Objective:To investigate high risk factors and prognostic factors in children with severe pneumonia via retrospective case control study,so as to provide references for doctors in basic-level hospitals to identify severe pneumonia in the early stage,take measures to intervene with,and transfer to other hospitals when necessary for reducing the mortality of severe pneumonia.Methods:Retrospective case-control study was adopted,164 children confirmed with severe pneumonia in our hospital from January 2014 to January 2019 were enrolled as the case group,and another 100 children who were diagnosed with mild pneumonia in the same department and with similar admission date(less than 8 weeks)were selected as the control group.Logistic regression was used to statistically analyze case data in two groups.Cox proportional hazards model was used to statistically analyze the prognostic factors of severe pneumonia.Results:Age<3 months(OR=5.210,95%CI=1.565 to 17.364),living in rural areas(OR=2.730,95%CI=1.016 to 7.331)and having the underlying disease(OR=5.620,95%CI=2.023 to 15.696)were independent risk factors for severe pneumonia.SpO2≤90%(SpO2≤90%vs.SpO2>90%,OR=1.520,95%CI=1.010 to 2.310)and multisystem complications(single system vs.multiple systems,OR=0.660,95%CI=0.445 to 0.978)were risk factors for a poor prognosis of severe pneumonia.Conclusion:Children with age<3 months,living in rural areas,and having the underlying disease are more likely to get severe pneumonia.SpO2≤90%and multisystem complications are factors to predict poor prognosis of severe pneumonia.Therefore,doctors in basic-level hospitals should strengthen the monitoring of high risk factors;identification in the early stage and early referral can reduce the mortality of severe pneumonia.

关 键 词：重症肺炎 危险因素 预后因素 COX风险模型 

分 类 号：R725[医药卫生—儿科]