摘要
目的分析脓毒症患儿临床特征、病原菌特点及预后。方法回顾性收集本院2021年1月至2022年6月期间收治的100例脓毒症患儿临床资料,分析临床特征、病原菌特点,以28d为研究终点,根据预后情况将患儿为生存组和死亡组,采用单因素及多因素Logistic回归分析患儿死亡的影响因素,采用受试者工作特征(ROC)曲线分析上述影响因素对患儿预后的预测价值。结果100例脓毒症患儿中,28d死亡22例,其死亡率为22.00%;最常见感染部位为肺部(60.00%);常见致病菌为革兰氏阴性菌(68.00%);单因素及多因素Logistic回归分析结果显示,序贯性器官功能衰竭评估(SOFA)、白蛋白(Alb)、血乳酸(Lac)、C反应蛋白(CRP)、降钙素(PCT)均是导致脓毒症患儿死亡的独立危险因素(P<0.05);ROC曲线分析结果显示,SOFA、Lac、Alb、CRP、PCT联合检测的线下面积均高于的单一检测(P<0.05),上述指标预测脓毒症患儿死亡的截断值分别为9.16分、3.84mmol/L、23.80g/L、33.99mg/L、5.43ng/L。结论儿童脓毒症死亡率较高,呼吸道为最常见感染部位,常见致病菌为革兰氏阴性菌,SOFA评分、Alb、Lac、CRP、PCT在评估患儿预后时具有良好的预测价值。
Objective To analyze the clinical characteristics,pathogenic bacteria characteristics and prognosis of children with sepsis.Methods Clinical data from 100 children with sepsis admitted to our hospital from January 2021 to June 2022 were retrospectively collected and the characteristics of clinical and pathogenic bacteria were analyzed.Children were divided into survival group and death group according to their survival conditions at 28 days.The factors of death of the children were analyzed by single-factor and multiple-factor logistic regression,and the predictive value of the influencing factors on the prognosis of the children was analyzed by the ROC curve.Results Among 100 children with sepsis,22 died at 28-day,with a mortality rate of 22.00%.The most common site of infection was the lung(60.00%).The common pathogenic bacteria are gram-negative bacteria(68.00%).Logistic regression analysis showed that sequential organ failure assessment(SOFA),albumin(Alb),blood lactic acid(Lac),C-reactive protein(CRP),calcitonin(PCT)were independent risk factors leading to the death of children with sepsis(P<0.05).The results of the ROC curve analysis showed that the area under the line of combined detection of SOFA,Lac,Alb,CRP and PCT was higher than that of single detection(P<0.05).The cutoff values of the above indicators to predict the death of children with sepsis were 9.16 points,3.84mmol/L,23.80 g/L,33.99mg/L,5.43ng/L,respectively.Conclusions The mortality rate of children with sepsis is high.The respiratory system is the most common infection site.The common pathogenic bacteria are gram-negative bacteria.The SOFA score,Alb,Lac,CRP,PCT have a good predictive value in evaluating the prognosis of children.
作者
严春宏
刘秀芳
林贤彬
傅小燕
Yan Chunhong;Liu Xiufang;Lin Xianbin;Fu Xiaoyan(Department of Pediatric Emergency Medicine,Huizhou Central People's Hospital,Huizhou,China)
关键词
脓毒症
儿童
临床特征
病原菌特点
预后
Sepsis
Children
Clinical characteristics
Characteristics of pathogenic bacteria
Prognosis
作者简介
通信作者:傅小燕,E-mail:523425770@qq.com
