营养风险对严重脓毒症患儿预后的影响研究  

The effect of nutritional risk on the prognosis of children with severe sepsis

作　　者：张小琴[1] 伍中华[1] 石明芳[1] ZHANG Xiaoqin;WU Zhonghua;SHI Mingfang(Department of Pediatrics,the First People's Hospital of Yibin,Yibin,Sichuan,644000,China)

机构地区：[1]宜宾市第一人民医院儿科,四川宜宾644000

出　　处：《临床急诊杂志》2021年第1期65-69,共5页Journal of Clinical Emergency

摘　　要：目的:探讨营养风险对严重脓毒症患儿预后的影响。方法:选取2017年2月-2020年2月期间我院儿科儿童重症监护病房(PICU)收治的226例严重脓毒症患儿为研究对象。于确诊为严重脓毒症时采用营养状况和生长风险筛查工具(STRONGkids)筛查患儿营养风险。根据STRONGkids评分结果将患儿分为高营养风险组(评分≥4分)89例,中低营养风险组(评分<4分)137例。比较两组临床资料;采用多因素Cox比例风险回归模型分析严重脓毒症患儿预后的独立危险因素;采用Kaplan-Meier生存曲线分析两组患儿28d累积生存率。结果:226例严重脓毒症患儿中存在高度营养风险89例(39.38%),中度营养风险70例(30.97%),低度营养风险67例(29.65%);高营养风险组APACHEⅡ评分、血清PCT、Lac水平高于中低营养风险组,血清ALB水平低于中低营养风险组(P<0.05);Cox回归分析显示,高营养风险是影响严重脓毒症患儿预后的独立危险因素(P<0.05);Kaplan-Meier法分析结果显示,高营养风险组率28d累积生存率低于中低营养风组(P<0.05)。结论:严重脓毒症患儿早期存在较高营养风险发生率,高营养风险是影响患儿预后的独立危险因素。Objective:To explore the effect of nutritional risk on the prognosis of children with severe sepsis.Methods:Two hundred and twenty-six children with severe sepsis admitted to the pediatric intensive care unit(PICU)of the first people's Hospital of Yibin from February 2017to February 2020were selected as the study objects.Nutritional status and growth risk screening tools(STRONGkids)were used to screen children's nutritional risk when they were diagnosed with severe sepsis.According to the results of STRONGkids,the children were divided into high nutrition risk group(total score≥4points)89cases,moderate and low nutrition risk group(total score<4points)137cases.The clinical data of the two groups were compared.Multivariate Cox proportional risk regression model was used to analyze the independent risk factors of prognosis in children with severe sepsis.Kaplan Meier survival curve was used to analyze the 28day cumulative survival rate of the two groups.Results:Among the 226children with severe sepsis,89(39.38%)had high nutritional risk,70(30.97%)had moderate nutritional risk and 67(29.65%)had low nutritional risk.Among the 226children with severe sepsis,159(70.35%)had nutritional risk,89(39.38%)had high nutritional risk,70(30.97%)had moderate nutritional risk and 67(29.65%)had low nutritional risk.The APACHEⅡscore,serum PCT and lac levels in high nutrition risk group were higher than those in moderate and low nutrition risk group,serum ALB levels in high nutrition risk group were lower than those in moderate and low nutrition risk group(P<0.05).Cox regression analysis showed that high nutritional risk was an independent risk factor for the prognosis of children with severe sepsis(P<0.05).Kaplan Meier analysis showed that the 28day cumulative survival rate of high nutritional risk group was lower than that of medium and low nutritional wind group(P<0.05).Conclusion:Children with severe sepsis have a higher incidence of nutritional risk in the early stage.High nutritional risk is an independent risk factor for the

关 键 词：严重脓毒症 营养风险 营养状况和生长风险筛查工具 预后 儿童 

分 类 号：R737.9[医药卫生—肿瘤]