84例ICU脓毒症患者致病菌分布特点及死亡相关因素研究
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摘要
目的探讨84例ICU脓毒症患者致病菌分布特点及死亡相关因素。方法回顾性分析2015年3月—2016年3月收治84例ICU脓毒症的临床资料。分析ICU脓毒症患者致病菌分布特点及死亡的危险因素。结果 84例ICU脓毒症患者以呼吸系统感染为主,共分离出98株致病菌菌株,其中以革兰阴性菌为主。84例ICU脓毒症病死率为30. 95%。年龄、脓毒症休克、APACHEⅡ评分、血乳酸及降钙素原为脓毒症患者死亡的危险因素,而血清白蛋白为脓毒症患者死亡的保护因素(P <0. 05)。结论 ICU脓毒症病死率高,临床应针对相关因素采取积极有效的干预措施,以此降低其病死率。
Objective To investigate distribution characteristics of pathogenic bacteria and death-related factors in 84 patients with sepsis in ICU. Methods Clinical data of 84 patients with sepsis in ICU admitted during March 2015 and March 2016 was retrospectively analyzed. Distribution characteristics of pathogenic bacteria and death-related factors in patients with sepsis in ICU were analyzed. Results The 84 patients with sepsis in ICU had respiratory infection mainly. A total of 98 pathogenic strains were isolated,in which gram-negative bacteria was the main one. Mortality rate was30. 95% in 84 patients with sepsis in ICU. Age,septic shock,acute physiology and chronic health evaluation II( APACHE II) score,blood lactic acid and procalcitonin were risk factors for death,while serum albumin was the protective factor of patients with sepsis( P < 0. 05). Conclusion Mortality rate of sepsis in ICU is high,and therefore positive and effective interventions should be given to reduce mortality rate of sepsis patients in ICU.
Objective To investigate distribution characteristics of pathogenic bacteria and death-related factors in 84 patients with sepsis in ICU. Methods Clinical data of 84 patients with sepsis in ICU admitted during March 2015 and March 2016 was retrospectively analyzed. Distribution characteristics of pathogenic bacteria and death-related factors in patients with sepsis in ICU were analyzed. Results The 84 patients with sepsis in ICU had respiratory infection mainly. A total of 98 pathogenic strains were isolated,in which gram-negative bacteria was the main one. Mortality rate was30. 95% in 84 patients with sepsis in ICU. Age,septic shock,acute physiology and chronic health evaluation II( APACHE II) score,blood lactic acid and procalcitonin were risk factors for death,while serum albumin was the protective factor of patients with sepsis( P < 0. 05). Conclusion Mortality rate of sepsis in ICU is high,and therefore positive and effective interventions should be given to reduce mortality rate of sepsis patients in ICU.
引文
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[13]李献平,于伟燕,赵彩彦.人血白蛋白治疗终末期肝病研究进展[J].实用肝脏病杂志,2017,20(1):115-119.
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[15]Artero A,Zaragoza R,Camarena J J,et al. Prognostic factors of mortality in patients with community-acquired bloodstream infection with severe sepsis and septic shock[J]. J Crit Care,2010,25(2):276-281.
[2]李志华,刘宣,葛勤敏,等. su PAR及PCT对脓毒症患者病情严重程度及预后的评判价值[J].中华急诊医学杂志,2015,24(6):629-633.
[3]杨秀芬,李栋梁,周庆明.脓毒症致肠功能衰竭研究进展[J].河北医科大学学报,2014,35(11):1357-1360.
[4]豆利军,王国平,闵榴芳,等.应用连续性血液净化治疗不同部位感染引起的脓毒症的效果研究[J].山西医药杂志,2016,45(18):2156-2159.
[5]斯重阳. SSC严重脓毒症和脓毒症国际指南2012[C].北京:第六届首都急危重症医学高峰论坛论文集,2013.
[6]叶钢. MEWS评分与APACHEⅡ评分预测重症医学科患者病情的比较[J].中国医药导刊,2016,18(7):690-692.
[7]徐华,赵双彪,郑伟华,等.重症监护室危重脓毒症病原菌分布及其预后分析[J].广东医学,2016,37(z2):35-37.
[8]宋明明,王旭,孙炳伟.脓毒症时中性粒细胞胞外诱捕网的研究进展[J].中华危重病急救医学,2015,27(2):152-154.
[9]任艺,邵旦兵,刘红梅,等. MEWS评分SCS评分和APACHEⅡ评分在评估急诊危重患者预后中的作用[J].中国急救医学,2013,33(8):711-714.
[10]程涛,张晓霞,彭鹏.脓毒症患者液体复苏终点指标的研究进展[J].医学研究杂志,2016,45(2):167-170.
[11]王燕,汤明荣.降钙素原检测在临床应用中的研究进展[J].检验医学与临床,2014,11(z2):113-115.
[12]张波,朱武,谢万华,等.新生儿败血症炎症细胞因子、降钙素原和内毒素的检测及临床意义[J].海南医学院学报,2016,22(22):2779-2781.
[13]李献平,于伟燕,赵彩彦.人血白蛋白治疗终末期肝病研究进展[J].实用肝脏病杂志,2017,20(1):115-119.
[14]陈建丽,徐艳霞,周茉,等.营养支持在严重脓毒症患儿中的应用研究[J].中国小儿急救医学,2014,21(5):292-295.
[15]Artero A,Zaragoza R,Camarena J J,et al. Prognostic factors of mortality in patients with community-acquired bloodstream infection with severe sepsis and septic shock[J]. J Crit Care,2010,25(2):276-281.