凉山彝族地区儿童脓毒症死亡的相关危险因素分析  

Analysis of Risk Factors Related to Sepsis Death in Children in Liangshan Yi Area

作　　者：周继敏[1] 花媛媛 石艳[1] 唐琳 高自军 蔡钊[4] 黄静[5] 张魏[6] 罗先秋 罗刚群 徐涛[9] 青鸿凌 Zhou Jimin;Hua Yuanyuan;Shi Yan(The First People's Hospital of Liangshan Prefecture,Xichang,Sichuan 615000,China)

机构地区：[1]凉山州第一人民医院,四川西昌615000 [2]西昌市人民医院,四川西昌615000 [3]美姑县人民医院,四川美姑616450 [4]昭觉县人民医院,四川昭觉616150 [5]凉山州第二人民医院,四川西昌615000 [6]凉山州中西医结合医院,四川西昌615000 [7]宁南县人民医院,四川宁南615400 [8]凉山州妇幼保健院,四川西昌615000 [9]冕宁县人民医院,四川冕宁615400 [10]会理县人民医院,四川会理615100

出　　处：《四川医学》2025年第1期44-49,共6页Sichuan Medical Journal

基　　金：凉山州科技计划项目(编号:22ZDYF0084)。

摘　　要：目的探讨凉山彝族地区儿童脓毒症死亡的相关危险因素,以利于早期认识、诊断脓毒症,提高脓毒症的抢救成功率,改善预后。方法凉山州10家医院参与了这项多中心、前瞻性、观察性研究,对2022年6月至2023年6月收治的脓毒症患儿个人基本资料进行搜集,包括性别、民族、年龄、入院主要原因、合并基础疾病、病原学及血生化指标、治疗、预后、pSOFA评分、PCIS评分等相关数据进行整理和分析。同时对相关因素进行单因素分析和Logistic回归分析,了解儿童脓毒症死亡的独立危险因素。结果单因素分析显示,原发疾病、血红蛋白水平、血小板水平、白蛋白水平、乳酸水平、钙水平、PCIS评分、pSOFA评分、有创呼吸机使用、液体复苏、MODS受累脏器数差异有统计学意义,与脓毒症死亡相关。将单因素分析结果中差异有统计学意义的11个影响因素进行多因素Logistic回归分析,结果显示原发疾病为神经系统疾病、乳酸水平、pSOFA评分3个影响因素与死亡有关(P<0.05)。结论儿童严重脓毒症死亡率高,高乳酸、高pSOFA评分、原发疾病为神经系统疾病是凉山彝族地区儿童脓毒症死亡的独立危险因素。Objective To explore relevant risk factors for mortality from sepsis in children in the Yi area of Liangshan,facilitate early recognition and diagnosis of sepsis,and improve survival rate,even prognosis.Methods Ten hospitals in Liangshan Prefecture participated in the prospective and observational study.From June 2022 to June 2023,personal basic information of study objects admitted was collected and analyzed,including gender,ethnicity,age,main reasons for admission,comorbidities,pathogenic and biochemical indicators,treatment,prognosis,pSOFA score,PCIS score,and other related data.Simultaneously conduct univariate analysis and Logistic regression analysis on relevant factors to find independent risk factors for mortality in children with sepsis.Results Univariate analysis showed that there were statistically significant differences in the original diseases,hemoglobin,platelets,albumin,lactate,calcium,PCIS score,pSOFA score,invasive ventilator use,fluid resuscitation,and the number of affected organs in MODS,which were associated with sepsis mortality.Multiple logistic regression analysis was conducted on these 11 statistically significant factors.It showed that neurological diseases,lactate,and pSOFA score were related to sepsis mortality(P<0.05).Conclusion The high mortality rate of severe sepsis in children is worthy of attention.High level of lactate,high pSOFA score,and the original neurological diseases,are independent risk factors for sepsis mortality in children in the Yi area of Liangshan.

关 键 词：儿童 脓毒症 死亡 危险因素 

分 类 号：R339.39[医药卫生—人体生理学] R729[医药卫生—基础医学]