标题：重症监护病房脓毒症患儿预后及其影响因素

      作者：李雨铮    (深圳市儿童医院呼吸二科，广东 深圳 518026)

      卷次： 2018年29卷13期

      【摘要】 目的 探讨重症监护病房脓毒症患儿预后的影响因素。方法 收集2013年1月至2016年12月在深圳市儿童医院儿童重症监护病房住院的164例脓毒症患儿的临床资料，采用多因素Cox比例风险回归分析影响患儿预后的危险因素。结果 164例患儿中死亡39例(23.8%)。单因素分析结果显示，死亡患儿的血小板计数、平均动脉压、PCIS分、血清白蛋白、24 h尿量明显低于存活患儿，休克和尿量感染发生率明显高于存活患儿，累及器官明显多于存活患儿，机械通气时间明显比存活患儿长，差异均有统计学意义(P<0.05)；Logistic回归分析结果显示，MODS、休克、PCIS评分、血小板计数、24 h尿量和血清白蛋白与脓毒症患儿死亡密切相关 (P<0.05)。结论 MODS、休克、PCIS评分、血小板计数、24 h尿量和血清白蛋白是导致脓毒症死亡的相关危险因素。
      【关键词】 脓毒症患儿；重症监护室；预后；影响因素
      【中图分类号】 R726 【文献标识码】 A 【文章编号】 1003—6350（2018）13—1879—03

Prognosis of children with sepsis in PICU and its influencing factors.
LI Yu-zheng. The Second Department ofRespiration, Shenzhen Children's Hospital, Shenzhen 518026, Guangdong, CHINA
【Abstract】 Objective To investigate the prognosis in children with sepsis in Pediatric Intensive Care Unit(PICU) and its influencing factor. Methods The clinical data from 164 children with sepsis admitted to PICU in Shen-zhen Children’s Hospital from January 2013 to December 2016 were retrospectively analyzed. The risk factors influenc-ing prognosis were analyzed by Cox proportional hazards regression. Results The mortality was 23.8% (39/164). Sin-gle factor analysis showed that, compared with children who survived, children who were died had significantly lowerplatelet count, lower mean arterial pressure, lower pediatric critical illness score (PCIS), lower serum albumin, and lower24 h urine volume, significantly higher incidence of shock and urine volume infection, significantly more cases of multi-ple organ dysfunction syndrome (MODS), and significantly longer time of mechanical ventilation (P<0.05). Logistic re-gression analysis showed that MODS, shock, PCIS score, platelet count, 24 h urine volume and serum albumin wereclosely related to the death of children with sepsis (P<0.05). Conclusion MODS, shock, PCIS, platelet count, 24 hurine volume, and the serum albumin are the associated risk factors leading to sepsis death.
      【Key words】 Children with sepsis; Pediatric Intensive Care Unit (PICU); Prognosis; Influencing factor·临床经验·doi:10.3969/j.issn.1003-6350.2018.13.031基金项目：2016年广东省深圳市卫生计生系统科研项目(编号：201606035)