凉山彝族自治州儿童脓毒症临床特征及实验室结果分析  

Clinical characteristics and laboratory results of sepsis in children in Liangshan Yi nationality area

作　　者：周继敏[1] 王科 石艳[1] 唐琳 高自军 蔡钊[4] 黄静 张魏 罗先秋 罗刚群 徐涛[9] 青鸿凌 ZHOU Jimin;WANG Ke;SHI Yan;TANG Lin;GAO Zijun;CAI Zhao;HUANG Jing;ZHANG Wei;LUO Xianqiu;LUO Gangqun;XU Tao;QING Hongling(Department of Pediatrics,the First People′s Hospital of Liangshan Yi Autonomous Prefecture,Liangshan,Sichuan 615000,China;Department of Pediatrics,Xichang People′s Hospital,Liangshan,Sichuan 615000,China;Department of Pediatrics,Meigu County People′s Hospital,Liangshan,Sichuan 616450,China;Department of Pediatrics,Zhaojue County People′s Hospital,Liangshan,Sichuan 616150,China;Department of Pediatrics,the Second People′s Hospital of Liangshan Yi Autonomous Prefecture,Liangshan,Sichuan 615000,China;Department of Pediatrics,Combined Traditional Chinese and Western Medicine Hospital of Liangshan Yi Autonomous Prefecture,Liangshan,Sichuan 615000,China;Department of Pediatrics,Ningnan County People′s Hospital,Liangshan,Sichuan 615400,China;Department of Pediatrics,Maternity and Child Health Hospital of Liangshan Yi Autonomous Prefecture,Liangshan,Sichuan 615000,China;Department of Pediatrics,Mianning County People′s Hospital,Liangshan,Sichuan 615400,China;Department of Pediatrics,Huili County People′s Hospital,Liangshan,Sichuan 615100,China)

机构地区：[1]四川省凉山彝族自治州第一人民医院儿科,四川凉山615000 [2]四川省凉山彝族自治州西昌市人民医院儿科,四川凉山615000 [3]四川省凉山彝族自治州美姑县人民医院儿科,四川凉山616450 [4]四川省凉山彝族自治州昭觉县人民医院儿科,四川凉山616150 [5]四川省凉山彝族自治州第二人民医院儿科,四川凉山615000 [6]四川省凉山彝族自治州中西医结合医院儿科,四川凉山615000 [7]四川省凉山彝族自治州宁南县人民医院儿科,四川凉山615400 [8]四川省凉山彝族自治州妇幼保健院儿科,四川凉山615000 [9]四川省凉山彝族自治州冕宁县人民医院儿科,四川凉山615400 [10]四川省凉山彝族自治州会理县人民医院儿科,四川凉山615100

出　　处：《检验医学与临床》2024年第9期1254-1258,共5页Laboratory Medicine and Clinic

基　　金：四川省凉山彝族自治州科技计划项目(22ZDYF0084)。

摘　　要：目的分析凉山彝族自治州脓毒症患儿的临床特征、实验室结果和流行病学数据,以期为儿童脓毒症的防治提供科学依据。方法收集2022年6月1日至2023年6月30日凉山彝族自治州10家医院收治的进行脓毒症筛查患儿的病例资料,整理并分析患儿的年龄、性别,发病季节、住院患者来源等一般资料,以及病原体特征、血液生化指标水平、治疗、预后转归情况、儿童序贯器官衰竭评分法(p-SOFA)评分、小儿危重病例评分法(PCIS)评分等。结果共筛查住院儿童18224例,最终192例患儿确诊为脓毒症(含脓毒性休克),发病率为1.05%。192例脓毒症患儿中男115例(59.90%),女77例(40.10%);彝族142例(73.96%),汉族50例(26.04%);29 d至12个月患儿所占比例最高,为56.77%(109/192),其次为6~12岁患儿[17.19%(33/192)]和1~3岁患儿[13.54%(26/192)];最常见的原发感染部位为呼吸系统130例(67.71%),其次是消化系统20例(10.42%);病原体检测结果显示,47例患儿病原体检测阳性,阳性率为24.48%,共检出56株病原菌,最常见的病原体为细菌(71.43%),以肺炎链球菌(25.00%)和流感嗜血杆菌为主(17.86%),其次为病毒(19.64%),以甲型流感病毒最多(10.71%);合并脏器功能障碍以呼吸功能障碍最多见(58.33%),神经系统功能障碍(27.08%)次之。192例脓毒症患儿中存活170例,死亡22例。结论凉山彝族自治州婴幼儿更易罹患脓毒症,且以呼吸道细菌感染为主,应加强对凉山彝族自治州婴幼儿呼吸道疾病的关注,并加强对婴幼儿疫苗接种的宣传,以降低患儿的病死率。Objective To study the clinical features,laboratory results and epidemiological data of children with sepsis in Liangshan Yi Autonomous Prefecture,and to provide scientific basis for the prevention and treatment of children with sepsis.Methods Data of 192 children with sepsis admitted to 10 hospitals in Liangshan Yi Autonomous Prefecture from June 12022 to June 302023 were collected,and general data such as age,gender,season of onset,source of hospitalized patients were compiled and analyzed,as well as characteristics of the pathogenic bacteria and levels of blood biochemical indexes,treatments,prognostic regressions,Pediatric Sequential Organ Failure Scoring Act(p-SOFA)score,and Pediatric Critical Illness Scoring(PCIS)score.Results A total of 18224 hospitalized children were screened in this study,and 192 children were finally diagnosed with sepsis(including septic shock),with a prevalence rate of 1.05%,including 115 males(59.90%)and 77 females(40.10%),142 cases(73.96%)were of Yi ethnicity,and 50 cases(26.04%)were of Han ethnicity;the highest prevalence rate was found among the children aged 29 d to 12 months,with a prevalence rate of 56.77%(109/192),followed by children aged 6 to 12 years[17.19%(33/192)]and children aged 1 to 3 years[13.54%(26/192)].The most common site of primary infection was the respiratory system in 130 cases(67.71%),followed by the gastrointestinal system in 20 cases(10.42%);the results of pathogenic bacteria testing showed that 47 children were positive for pathogenesis,with a positivity rate of 24.48%,and a total of 56 strains of pathogens were detected,with the most common pathogens being bacteria(71.43%),with Streptococcus pneumoniae(25.00%)and Haemophilus influenzae predominating(17.86%);followed by viruses(19.64%),with influenza A virus being the most common(10.71%);combined organ dysfunction was most common with respiratory dysfunction(58.33%),followed by neurologic dysfunction(27.08%).Among 192 children with sepsis,170 cases survived and 22 cases died.Conclusion Infants and young c

关 键 词：儿童 脓毒症 临床特征 实验室结果 

分 类 号：R725.9[医药卫生—儿科]