中老年糖尿病脓毒症患者临床特征及影响预后的危险因素分析

发布时间：2018-04-13 23:17

本文选题：中老年糖尿病 + 脓毒症　；参考：《中华医院感染学杂志》2017年18期

【摘要】：目的分析糖尿病合并脓毒症患者的临床特征及影响预后的危险因素。方法收集2014年1月1日-2015年12月31日住院治疗的40岁以上脓毒症患者454例临床资料,其中糖尿病脓毒症组(研究组)98例,非糖尿病脓毒症组(对照组)356例,比较两组患者临床基本资料及感染原发部位分布,并依据预后将糖尿病脓毒症患者分为死亡组和存活组,对其合并症、手术及操作等进行单因素卡方分析和多因素logistic回归分析。结果研究组和对照组在年龄、性别、平均住院费用上差异均无统计学意义,感染原发部位前3位依次是肺部感染、胆囊/胆道感染、尿路感染;研究组肝脓肿分布率(8.16%)和皮肤软组织分布率(9.18%)高于对照组(3.38%,3.66%,P0.05),依据预后将糖尿病合并脓毒症分为死亡组(46例)和存活组(52例),死亡组年龄≥60岁、真菌感染、肺部感染、两个以上脏器衰竭、使用呼吸机比率均高于存活组,logistic回归结果显示,恶性肿瘤和使用呼吸机是糖尿病合并脓毒症死亡的危险因素(P0.05)。结论糖尿病合并脓毒症未增加脓毒症患者住院天数、住院费用;但两组在原发感染部位构成方面有所不同,肝脓肿和皮肤软组织感染在糖尿病脓毒症组高于非糖尿病组,使用呼吸机和恶性肿瘤是糖尿病合并脓毒症患者死亡的独立的危险因素。
[Abstract]:Objective to analyze the clinical features and prognostic factors of diabetic patients with sepsis.Methods from January 1, 2014 to December 31, 2015, the clinical data of 454 patients with sepsis over 40 years old who were hospitalized from January 1, 2014 to December 31, 2015 were collected, including 98 cases of diabetic sepsis group (study group) and 356 cases of non-diabetic sepsis group (control group: 356 cases).The patients were divided into death group and survival group according to the prognosis. The complications, operation and operation were analyzed by single factor chi-square analysis and multivariate logistic regression analysis.Results there was no significant difference in age, sex and average hospitalization cost between the study group and the control group. The first three primary sites of infection were lung infection, gallbladder / biliary tract infection and urinary tract infection.The distribution rate of liver abscess (8.16) and skin and soft tissue (9.18) in the study group was higher than that in the control group (3.38%). According to the prognosis, the diabetic patients with sepsis were divided into death group (46 cases) and survival group (52 cases). The age of death group was more than 60 years old, fungal infection, pulmonary infection.The results of logistic regression showed that malignant tumor and ventilator were the risk factors for death of diabetes mellitus complicated with sepsis.Conclusion Diabetes mellitus with sepsis did not increase the length of stay and the cost of hospitalization, but the composition of primary infection site was different between the two groups, and liver abscess and skin soft tissue infection were higher in diabetic sepsis group than in non-diabetic group.Ventilator use and malignant neoplasms are independent risk factors for death in diabetics with sepsis.
【作者单位】：新疆医科大学第一附属医院感染管理科;新疆医科大学第一附属医院新疆代谢性疾病重点实验室;
【基金】：新疆维吾尔自治区自然科学基金资助项目(2016D01C297)
【分类号】：R459.7;R587.1

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