本文關鍵詞：膿毒癥并發(fā)毛細血管滲漏綜合征的危險因素分析　出處：《中國全科醫(yī)學》2016年36期 　論文類型：期刊論文

  更多相關文章： 膿毒癥 毛細血管滲漏綜合征 危險因素

【摘要】：目的探討膿毒癥并發(fā)毛細血管滲漏綜合征(CLS)的危險因素,為臨床早期篩查、及時干預提供理論依據(jù)。方法收集2007年6月—2015年6月海南省人民醫(yī)院兒科收治的321例膿毒癥患兒的臨床資料,根據(jù)是否并發(fā)CLS將患兒分為非CLS組298例和CLS組23例。以患兒入院為觀察起點,死亡或出院為觀察終點。比較兩組患兒臨床治療結果及年齡、性別、營養(yǎng)不良發(fā)生情況、白細胞計數(shù)(WBC)、血清降鈣素原(PCT)水平、血清C反應蛋白(CRP)水平、空腹血糖≥6.67 mmol/L發(fā)生情況、血清腫瘤壞死因子α(TNF-α)水平、血清乳酸水平、凝血功能障礙發(fā)生情況、小兒危重癥評分(PCIS)、休克發(fā)生情況、多器官功能障礙綜合征(MODS)累及臟器≥3個發(fā)生情況、膿毒癥治療1 h內抗生素應用情況及6 h目標復蘇治療情況;采用多因素Logistic回歸分析膿毒癥患兒并發(fā)CLS的影響因素。結果非CLS組患兒治愈率高于CLS組患兒(χ2=41.309,P0.001)。兩組患兒年齡、性別、營養(yǎng)不良發(fā)生率、WBC、膿毒癥治療1 h內抗生素應用率、6 h目標復蘇治療率比較,差異無統(tǒng)計學意義(P0.05);CLS組患兒血清PCT水平、血清CRP水平、血糖≥6.67 mmol/L發(fā)生率、血清TNF-α水平、血清乳酸水平、凝血功能障礙發(fā)生率、休克發(fā)生率、MODS累及臟器≥3個發(fā)生率高于非CLS組,PCIS低于非CLS組(P0.05)。多因素Logistic回歸分析結果顯示,血清乳酸水平〔OR=2.609,95%CI(1.402,4.857)〕、PCIS〔OR=0.634,95%CI(0.497,0.808)〕、休克〔OR=0.124,95%CI(0.024,0.643)〕、MODS累及臟器≥3個〔OR=0.120,95%CI(0.021,0.676)〕是膿毒癥患兒發(fā)生CLS的影響因素(P0.05)。結論血清乳酸水平升高、PCIS降低、休克、MODS累及臟器≥3個的膿毒癥患兒發(fā)生CLS的可能性較大,臨床應注意重點監(jiān)測。
[Abstract]:Objective to investigate the sepsis complicated with capillary leak syndrome (CLS) risk factors for early clinical screening, timely intervention and provide a theoretical basis. Methods clinical data of 321 cases of sepsis were collected from June 2007 to June 2015 in Department of Pediatrics of Hainan Provincial People's Hospital pus, according to whether complicated with CLS were divided into non CLS group 298 cases and group CLS 23 children in the hospital for observation. In cases of death or discharge in order to observe the starting point and end point. Two groups were compared the clinical results and age, sex, malnutrition, white blood cell count (WBC), serum procalcitonin (PCT) level of serum C reactive protein (CRP) level, the incidence of fasting blood glucose than 6.67 mmol/L, serum tumor necrosis factor alpha (TNF- alpha) levels, serum lactate levels, the incidence of blood coagulation dysfunction, pediatric critical illness score (PCIS), the incidence of shock, multiple organ dysfunction syndrome (MODS) involving the dirty For more than 3 cases of sepsis treatment within 1 h of the use of antibiotics and 6 h target recovery treatment; influence factors using multivariate Logistic regression analysis of sepsis in children with CLS. Results the cure rate of the group CLS was higher than that in CLS group (2=41.309, P0.001). The two groups of children with age. Gender, the incidence of malnutrition, WBC treatment, 1 h antibiotic application rate of sepsis, compared the rate of 6 h target recovery treatment, the difference was not statistically significant (P0.05); the serum level of PCT in group CLS, the serum level of CRP, the incidence rate of blood glucose greater than 6.67 mmol/L, the serum TNF- levels, serum lactate levels, incidence the rate of blood coagulation dysfunction, the incidence of shock, involving more than 3 MODS organs was higher than non CLS group, PCIS was lower than that in non CLS group (P0.05). Multivariate Logistic regression analysis showed that serum lactic acid level of OR=2.609,95%CI (1.402,4.857), PCIS OR=0.634,95%CI (0.497,0. 808), shock OR=0.124,95%CI (0.024,0.643), MODS = 3 OR=0.120,95%CI involving organs (0.021,0.676) is the influencing factors in children with sepsis CLS (P0.05). Conclusion increased serum lactic acid level decreased PCIS, MODS shock, the organ involved more than 3 children with sepsis had the possibility of CLS larger clinical attention should be paid to focus on monitoring.

【作者單位】： 海南省人民醫(yī)院兒科;
【分類號】：R459.7
【正文快照】： 毛細血管滲漏綜合征(capillary leak syndrome,CLS)是指由于毛細血管內皮細胞損傷,血管通透性增加,導致大量血漿小分子蛋白滲漏到組織間隙,從而出現(xiàn)全身廣泛的水腫、低蛋白血癥、急性腎缺血、低血容量休克等表現(xiàn)的一組臨床綜合征[1]。引起CLS的病因較多,大多系膿毒癥所致。CLS

【相似文獻】

相關期刊論文 前10條

1 劉學英;魏艷蘇;李蘭鳳;任志萍;;小兒膿毒癥28例觀察及護理[J];河北醫(yī)藥;2008年04期

2 袁志強,彭毅志;新的腎透療法防治膿毒癥[J];中華燒傷雜志;2000年02期

3 孫成棟;張淑文;董軍;;膿毒癥臨床實驗免疫指標研究進展[J];中國危重病急救醫(yī)學;2005年12期

4 張連陽;;膿毒癥治療有哪些進展?[J];創(chuàng)傷外科雜志;2007年01期

5 劉明偉;蘇美仙;黃青青;;膿毒癥的免疫抑制及治療策略[J];中國全科醫(yī)學;2007年08期

6 王玉紅;周榮斌;;拮抗腎素-血管緊張素-醛固酮系統(tǒng)可能成為治療膿毒癥的新策略[J];臨床急診雜志;2011年04期

7 丁榆;李杏崧;;重度膿毒癥引起嚴重血小板減少患者的護理[J];當代護士(�？瓢�);2011年10期

8 董紅巖;陳圓圓;;膿毒癥88例的護理[J];中國誤診學雜志;2012年02期

9 王正國;;當前膿毒癥研究的思考[J];解放軍醫(yī)學雜志;2012年11期

10 馬朋林;;認識與挑戰(zhàn):膿毒癥流行病學變化的啟示[J];解放軍醫(yī)學雜志;2012年11期

相關會議論文 前10條

1 張振輝;陳曉輝;林s鉅，

本文編號：1369670