本文關(guān)鍵詞：膿毒血癥病例329例臨床特征及治療情況分析　出處：《重慶醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 膿毒血癥 臨床特征 治療

【摘要】：目的：膿毒血癥為威脅生命的重癥感染,對診斷為膿毒血癥患者的臨床特征、實(shí)驗(yàn)室檢查結(jié)果情況及治療進(jìn)行分析,為臨床上對該病的診斷及治療提供依據(jù)。方法：收集2013年1月～2014年10月,我院全院收治病人中出院診斷為膿毒血癥的患者臨床資料,進(jìn)行回顧性分析(診斷、發(fā)病誘因、伴隨的疾病、臨床特征及治療等),統(tǒng)計學(xué)方法采用t檢驗(yàn)或卡方檢驗(yàn)。結(jié)果：本組患者一共有329例,其中男性患者155例(47.1%),女性患者1 74例(52.9%)；61-80歲150例(45.6%),81-92歲37例(11.2%),發(fā)病的誘因以慢性疾病、手術(shù)后為主(158/329,48.0%),主要表現(xiàn)均為發(fā)熱(92.4%),發(fā)熱程度以中高熱為主(83.0%),平均發(fā)熱時間較長,1天~3+月,伴有其他系統(tǒng)疾病中以泌尿道疾病尤為突出,實(shí)驗(yàn)室檢查中血常規(guī)138例WBC10×109／L(41.9%),246例中性粒百分比75%(74.8%),白細(xì)胞低于正常值有23例(7.0%),306例降鈣素原異常,平均值為23.4；最高200(13例)；C反應(yīng)蛋白有197例異常(59.9%),平均值90,103例血沉異常(31.3%),平均值61；轉(zhuǎn)氨酶升高93例(28.2%),1例重度升高(400 u/L,0.03%),高達(dá)1550/1750 U/L,肌酐升高113例(34.3%),最高達(dá)814umol/L,平均值為183.1 umol/L;有123例凝血功能PTA出現(xiàn)異常(37.4%),平均值為53.8%；血培養(yǎng)陽性163例,其中金黃色葡萄球菌13例(8.0%),MASA 6例,大腸埃希菌60例(36.8%),產(chǎn)ESBL酶23例,肺炎克雷伯菌16例(9.8%),鮑曼不動桿菌14例(8.6%),銅綠假單胞菌13例(8.0%),屎腸球菌4例(2.5%),表皮葡萄球菌4例(2,5%),人葡萄球菌5例(3.1%),溶血葡萄球菌4例(2.5%),白假絲酵母4例(2.5%),其他陽性球菌12例(7.4%),革蘭陰性桿菌14例(8.6%)。多種抗生素被單獨(dú)或者聯(lián)合使用,最常用的抗生素為帕尼培南。結(jié)論：本組膿毒血癥患者分布以感染科,ICU為主,發(fā)病特征為中老年(大于60歲),免疫功能低下合并慢性疾病患者為主(26.5%),平均體溫為39.3℃,炎癥指標(biāo)以降鈣素原異常比例最高,肝腎功能及凝血功能異常比例不到50%,但血培養(yǎng)陽性病例所占比例較高(49.5%),多重耐藥菌株占40%,最常用的藥物是碳青霉烯類,總體治療效果較好(好轉(zhuǎn)及治愈率達(dá)80.9%)。
[Abstract]:Objective: sepsis is a life-threatening severe infection, the diagnosis of clinical characteristics of patients with sepsis, situation and treatment analysis of laboratory results, and provide the basis for the diagnosis and treatment of the disease in clinic. Methods: from January 2013 to October 2014, patients admitted in our hospital hospital discharge diagnosis of clinical data of patients with sepsis the retrospective analysis (diagnosis, predisposing factors, concomitant diseases, clinical features and treatment etc.), statistical methods using t test or chi square test. Results: the group of patients with a total of 329 cases, in which 155 cases of male patients (47.1%), 174 cases of female patients (52.9%); 61-80 150 (45.6% cases), 37 cases of 81-92 years old (11.2%), the cause of the disease to chronic diseases, mainly after surgery (158/329,48.0%), mainly were fever (92.4%), the degree of fever in hyperpyrexia (83%), the average long duration of fever, 1 days ~3 +鏈，

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