急性脓毒症型类鼻疽的临床特征及预后的影响因素分析  

Analysis on influencing factors of clinical features and prognosis of acute sepsis type of melioidosis

作　　者：王秋婷[1] 石慧芳[1] 廉芳 李明 林石宁 WANG Qiuting;SHI Huifang;LIAN Fang;LI Ming;LIN Shining(Department of Respiratory Medicine,the Second Affiliated Hospital of Hainan Medical College,Haikou,570311,China;Department of Laboratory Medicine, the Second Affiliated Hospital of Hainan Medical College)

机构地区：[1]海南医学院第二附属医院呼吸科,海口570311 [2]海南医学院第二附属医院检验科

出　　处：《临床急诊杂志》2022年第4期265-269,共5页Journal of Clinical Emergency

基　　金：海南省卫生健康行业科研项目(No:2001320241A2008)。

摘　　要：目的:观察急性脓毒症型类鼻疽的临床特征,并针对性分析其预后的影响因素。方法:选取2018年1月—2021年1月期间我院收治的80例急性脓毒症型类鼻疽患者作为研究对象,观察记录所有患者的临床特征,并记录所有患者的预后(病死)情况,根据预后情况分为不良组与良好组,设计基线资料统计表,详细统计两组患者的基线资料,分析急性脓毒症型类鼻疽预后的影响因素。结果:全部患者均有畏寒、发热,另有咳嗽、咳痰,胸闷气促等主要临床症状,主要体征有肺部啰音、皮肤脓肿、肝脾肿大;80例急性脓毒症型类鼻疽患者经治疗后病死26例,病死率为32.50%(26/80),纳入不良组;54例存活,存活率为67.50%(54/80),纳入良好组;不良组与良好组患者的出现症状至接受治疗时间、治疗方法、用药疗程比较差异有统计学意义(P<0.05),组间其他资料比较差异无统计学意义(P>0.05);经Cox回归分析结果显示,年龄大、出现症状至接受治疗时间长是急性脓毒症型类鼻疽患者预后不良的影响因素(HR>1,P<0.05),用药疗程长是急性脓毒症型类鼻疽患者预后不良的保护因素(HR<1,P<0.05)。结论:急性脓毒症型类鼻疽主要临床特征较为复杂,预后不良风险较高,其中年龄大、出现症状至接受治疗时间长,用药疗程短可能是患者预后不良的影响因素。Objective:To observe the clinical features of acute sepsis type of melioidosis,and target analyze the influencing factors of its prognosis.Methods:Eighty patients patients with acute sepsis type of melioidosis treated in our hospital from January 2018 to January 2021 were selected as the research subjects.The clinical characteristics of all patients were observed and recorded,and the prognosis(death from illness) of all patients was recorded.According to the prognosis,they were divided into the poor group and the good group.The statistical table of baseline data was designed.The baseline data of patients in the two groups was counted in detail.The influencing factors of prognosis of acute sepsis type of melioidosis were analyzed and found out.Results:All patients had the main clinical features of chills,fever,cough,expectoration,chest tightness and shortness of breath.The main signs were pulmonary rales,skin abscess,hepatosplenomegaly.Among 80 patients with acute sepsis type of melioidosis,after treatment,26 died,with a mortality of 32.50%(26/80),were included in the poor group;54 survived,with a survival rate of 67.50%(54/80),were included in the good group.Compare the time from symptom occurance to treatment,treatment method and course of treatment of patients in the good group and the poor group,the difference was statistically significant(P<0.05).There was no statistically significant difference in other data between the two groups(P>0.05).The results of Cox regression analysis showed that older age and longer time from symptom occurance to treatment were the influencing factors of poor prognosis in patients with acute sepsis type of melioidosis(HR>1,P>0.05),long course of medication was a protective factor for poor prognosis of patients with acute sepsis type of melioidosis(HR<1,P<0.05).Conclusion:The main clinical features of acute sepsis type of melioidosis are complicated,and the risk of poor prognosis is high.Older age,longer time from symptom occurance to treatment and shorter course of treatment may be

关 键 词：类鼻疽 脓毒症 临床特征 预后 影响因素 

分 类 号：R631[医药卫生—外科学]