新生儿感染性休克的死亡危险因素分析

发布时间：2018-05-13 16:27

本文选题：新生儿感染性休克 + 死亡　；参考：《中华医院感染学杂志》2017年09期

【摘要】：目的探讨新生儿感染性休克死亡情况及危险因素,为临床诊疗方案的制定提供理论依据。方法回顾性分析2006年1月-2016年7月收治的81例新生儿感染性休克患儿的临床资料,根据患儿的治疗转归,将发生死亡的42例分为A组,将存活下来的39例分为B组;对比两组患儿的各项临床资料,通过多因素logistic回归分析探讨新生儿感染性休克致死的高危因素。结果 81例新生儿感染性休克的病例中,死亡42例,病死率为51.85%;A组呼吸系统功能障碍发生率为95.24%,中枢神经系统功能障碍发生率为95.24%,消化系统功能障碍发生率为80.95%,均显著高于B组(P0.05);A组不合理抗菌方案比例、MODS所累及脏器数目、血清乳酸水平、血糖水平和C-反应蛋白水平均显著高于B组,而PCIS评分结果、白细胞计数、血小板计数、白蛋白水平、均显著低于B组(P0.05);多因素logistic回归分析结果显示,不合理抗菌方案、MODS所累及脏器数目、血清乳酸水平、白蛋白水平是新生儿感染性休克死亡的高危因素(P0.05)。结论不合理抗菌方案、MODS所累及脏器数目、血清乳酸水平、白蛋白水平是新生儿感染性休克死亡的高危因素,临床应采取相应的干预措施以提高临床治疗效果,改善患儿的预后。
[Abstract]:Objective to investigate the death status and risk factors of neonatal septic shock and to provide theoretical basis for clinical diagnosis and treatment. Methods the clinical data of 81 neonates with septic shock admitted from January 2006 to July 2016 were retrospectively analyzed. According to the outcome of treatment, 42 cases of death were divided into group A and 39 cases of survival were divided into group B; The high risk factors of neonatal septic shock death were analyzed by multivariate logistic regression analysis. Results of the 81 cases of neonatal septic shock, 42 died. The morbidity of respiratory dysfunction, central nervous system dysfunction and digestive system dysfunction in group A were 95.24g, 95.24and 80.95respectively, which were significantly higher than those in group B (P 0.05), and the number of organs involved in mods was significantly higher than that in group B (P 0.05). Serum lactate level, blood glucose level and C- reactive protein level were significantly higher than those in group B, while the results of PCIS score, white blood cell count, platelet count and albumin level were significantly lower than those in group B (P 0.05). The number of organs involved in mods, the level of serum lactate and albumin were the high risk factors of neonatal septic shock death. Conclusion the number of organs involved in mods, the level of serum lactic acid and the level of albumin are the high risk factors of neonatal septic shock death. The clinical intervention should be taken to improve the clinical effect and improve the prognosis of neonates with septic shock.
【作者单位】：三门峡市中心医院新生儿科;
【基金】：河南省教育厅科学技术研究重点基金资助项目(142102410126)
【分类号】：R722.1

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