感染性休克患者临床流行病学分析

发布时间：2018-07-10 02:38

本文选题：感染性休克 + 临床　；参考：《中华医院感染学杂志》2014年06期

【摘要】：目的探讨感染性休克的临床流行病学特点,为临床提高诊治水平提供参考依据。方法选择2010年1月1日-2013年2月28日收住的感染性休克患者98例为研究对象,采用回顾性分析方法对临床流行病学特点进行分析,根据结局分为存活组(63例)与死亡组(35例),对患者的年龄分布、发病季节、职业、地域分布、血常规、C-反应蛋白、血气分析、血白蛋白等进行对比分析,所有数据录入Excel表格进行处理,计数资料采用χ2检验。结果 98例感染性休克患者死亡35例,病死率35.71%;死亡组年龄60岁患者占77.14%;感染性休克患者冬季发病率最高,占39.80%,与其他季度比较差异有统计学意义(P0.01),死亡组患者则以夏冬季节明显,差异有统计学意义(P0.05);基础疾病以肺、脑、胆道疾病最常见,死亡组患者则以结肠疾病、慢性肝病、骨折长期卧位患者较高;感染性休克以肺部感染最多见,差异有统计学意义(P0.01),死亡组患者以腹膜炎、尿路感染较低;临床症状以发热、咳嗽、呕吐、心率120/min等为主;死亡组患者白细胞明显下降、CRP明显增高,PaCO2明显下降或增高及血乳酸增高与病死率增高有关,临床各项指标两组比较差异均有统计学意义(P0.01);检出病原菌以大肠埃希菌、肺炎克雷伯菌、肺炎链球菌、肠球菌属多见。结论感染性休克临床表现不典型、病情重、进展迅速,尤其是年老患者、寒冷和高温季节,白细胞、血小板、白蛋白明显下降,CRP、血乳酸明显增高者,病死率高。
[Abstract]:Objective to investigate the clinical epidemiological characteristics of septic shock and to provide reference for clinical diagnosis and treatment. Methods from January 1, 2010 to February 28, 2013, 98 patients with septic shock were selected as subjects, and the clinical epidemiological characteristics were analyzed by retrospective analysis. According to the outcome, the patients were divided into survival group (63 cases) and death group (35 cases). The age distribution, onset season, occupation, regional distribution, blood routine C-reactive protein, blood gas analysis and serum albumin were compared and analyzed. All the data were recorded in Excel tables and the count data were checked by 蠂 2 test. Results among 98 patients with septic shock, 35 died, the mortality was 35.71, the age of 60 years old was 77.14, the incidence of septic shock in winter was the highest, The difference was statistically significant compared with other quarters (P0.01), and that of the patients in the death group was obvious in summer and winter (P0.05), the most common diseases were lung, brain and biliary tract diseases, and the patients in the death group were colon disease and chronic liver disease. The incidence of septic shock was higher in patients with long lying position of fracture, the most of septic shock was pulmonary infection (P0.01), the patients in death group were peritonitis and urinary tract infection were lower, the clinical symptoms were fever, cough, vomiting, heart rate 120/min and so on, the main clinical symptoms were fever, cough, vomiting, heart rate 120/min and so on. In the death group, the levels of Paco _ 2 and blood lactic acid were significantly decreased or increased. There were significant differences in clinical indexes between the two groups (P0.01), the pathogenic bacteria were Escherichia coli, and there was no significant difference between the two groups (P0.01). Klebsiella pneumoniae, Streptococcus pneumoniae, Enterococcus are common. Conclusion the clinical manifestations of septic shock are atypical, severe and rapid progress, especially in the elderly patients, cold and high temperature season, white blood cells, platelets, albumin significantly decreased CRP, blood lactic acid significantly increased, the death rate is high.
【作者单位】：浙江省新昌县人民医院感染科;
【基金】：绍兴市科技计划基金资助项目(2010D10005)
【分类号】：R181.32

【相似文献】