儿童麻疹合并重症肺炎死亡危险因素分析  

Analysis of risk factors of death from measles complicated by severe pneumonia in children Analysis of mortality risk factors of measles complicated with severe pneumonia in children

作　　者：孙玲[1] 崔晓薇[1] 孙一硕 周晓强[1] 温婵[1] SUN Ling;CUI Xiaowei;SUN Yishuo(Hebei Provincial Children’s Hospital,Hebei,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院医务处,石家庄市050031

出　　处：《河北医药》2021年第2期267-270,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20150561)。

摘　　要：目的探讨麻疹合并重症肺炎患儿死亡危险因素,为麻疹合并重症肺炎死亡防控提供依据。方法回顾性分析2011年至2019年确诊并住院治疗的191名麻疹合并重症肺炎患儿的基本情况、临床特征、实验室检查、治疗和疾病转归等资料,根据疾病转归分为死亡组(10例)和存活组(181例);采用单因素分析,比较患儿基本情况、临床症状、实验室检查、呼吸机治疗情况等方面的差异;采用Logistic回归分析模型分析患儿死亡的危险因素。结果191例麻疹合并重症肺炎患儿中,死亡10例,病死率为5.23%;单因素分析显示:死亡组和存活组在既往病史、现居住地、心肌损害、心力衰竭、呼吸衰竭、CPAP使用天数、有创呼吸机使用天数等方面差异有统计学意义(P<0.05);多因素Logistic回归分析显示:既往病史(OR=1.048,95%CI:1.004~1.606)、呼吸衰竭(OR=1.067,95%CI:1.006~1.793)、有创呼吸机使用天数(OR=1.668,95%CI:1.497~1.899)是麻疹合并重症肺炎患儿死亡的独立危险因素。结论患儿既往病史、呼吸衰竭、有创呼吸机使用天数是麻疹合并重症肺炎患儿死亡的独立危险因素。Objective To investigate the risk factors of death in children with measles complicated by severe pneumonia,and to provide evidence for the prevention and control of death from measles complicated with severe pneumonia.Methods The clinical data about 191 children patients with measles complicated by severe pneumonia who were diagnosed and treated in our hospital from 2011 to 2019 were retrospectively analyzed,which included basic information,clinical features,laboratory examinations,treatment and disease outcome.According to the disease outcome,these patients were divided into death case group(n=10)and survival case group(n=181).Single factor analysis was used to compare the differences in children’s basic information,clinical symptoms,laboratory examinations,and ventilator treatment,and logistic regression analysis model was used to analyze the risk factors of death in the patients.Results Among the 191 children with measles complicated by severe pneumonia,10 cases died,with the death rate being 5.23%.Univariate analysis showed that there were significant differences in the past medical history,current residence,myocardial damage,heart failure,respiratory failure,and days of CPAP use and the length of invasive ventilator use between death case group and survival case group(P<0.05).Multivariate logistic regression analysis showed that past medical history,respiratory failure and the length of invasive ventilator use were independent risk factors for death in children with measles complicated by severe pneumonia.Conclusion The past medical history,respiratory failure,and the length of invasive ventilator use are the independent risk factors for death in children patients with measles complicated by severe pneumonia.

关 键 词：儿童 麻疹 重症肺炎 死亡 危险因素 

分 类 号：R511.1[医药卫生—内科学] R563.1[医药卫生—呼吸系统]