儿童重症监护室90例脓毒症患儿死亡的相关因素分析

摘要

Objective To explore related factors for death of children with sepsis in pediatric intensive care unit (PI-CU). Methods Ninety children with sepsis from February 2007 to September 2011 in our PICU were divided into live group th group. The variables of basic diseases, complications, and treatment measures were analyzed by univariate and multivariate analysis. Results Univariate analysis showed statistically significant difference between the two groups in mean arterial pressure, number of platelets, urinary tract infection and MODS affected organs, PCIS, highest PRISM in seven days, shock, capillary refill time, 24 h urine and serum albumin (P<0.05). Multivariate analysis showed a significant correlation between shock, MODS affected organs, 24 h urine, PCIS, number of platelets, serum albumin and death. Conclusion PCIS, shock, MODS affected organs, 24 h urine, thrombocytopenia, and serum albumin are the risk factors for death. The correct understanding of these factors can provide an important reference for the diagnosis and treatment of sepsis.%目的 探讨儿童重症监护室(PICU)脓毒症患儿死亡的相关因素.方法 将我院PICU在2007年2月至2011年9月间收治的90例脓毒症患儿分为存活组和死亡组,对基础疾病、并发症及治疗措施等方面的变量进行单因素分析,并且应用Logistic回归做多因素分析.结果 通过单因素分析显示存活患儿的平均动脉压、血小板数、尿路感染、MODS受累脏器、PCIS分、7d内最高PRISM、休克、毛细血管再充盈时间、24 h尿量及血清白蛋白与死亡患儿对比,差异具有统计学意义(P＜0.05).Logistic多因素分析显示休克、MODS受累脏器、24 h尿量、PCIS评分、血小板数目及血清白蛋白与脓毒症患儿死亡的密切相关.结论 PCIS分、休克、MODS受累脏器、24 h尿量、血小板减少及血清白蛋白是导致脓毒症死亡的相关危险因素,对其正确的认识可为临床的诊断及治疗提供参考依据.