感染性休克患儿病死率和死亡危险因素分析

Predictors and risk factors of mortality in pediatric patients with septic shock

目的探讨感染性休克患儿病死率及其死亡危险因素。方法采用回顾性研究方法,研究对象为72例感染性休克患儿,其中好转存活36例,死亡36例;利用SPSS 15.0的Logistic回归分析两组临床资料的死亡危险因素。结果感染性休克患儿的病死率高达50.0%;死亡组的收缩压、舒张压、平均动脉压、血糖、pH、血清胆固醇、血清白蛋白和入院24 h尿量与存活组比较,差异均有统计学意义。Logistic回归分析显示,模型检验χ2=26.781,P=0.000,有统计学意义。入院24 h尿量、舒张压、平均动脉压及白蛋白是危险因素(OR值、95%可信区间分别为5.197,1.359～19.878;1.102,1.020～1.191;1.125,1.025～1.234;1.120,0.996～1.259)。随着功能障碍器官数目的增加,病死率逐渐升高。结论24 h尿量、舒张压、平均动脉压和血清白蛋白,可作为感染性休克患儿预后不良和疾病严重性的预测指标。

Objective To assess the risk factors of mortality in pediatric patients with septic shock. Methods Seventy-two cases were collected （36 survival cases and 36 deceased cases）. The risk factors associated with mortality in pediatric patients with septic shock were analyzed by logistic regression prospectively. Results The overall mortality was 50%, which was very high. There were significant differences between survivor patients and deceased patients in systolic blood pressure （SBP）, diastolic blood pressure （DBP）, mean arterial pressure （MAP）, blood glucose, pH, serum cholesterol, serum albumin, amount of 24 hour urine, and the number of organs dysfunction etc. The more organs dysfunctioned, the higher mortality occurred. Conclusions Amount of 24 hour urine, DBP, MAP and serum albumin are the best indicators of adverse prognosis and serious illness.