影响婴儿捂热综合征预后的相关因素分析

Prognostic Risk Factors of Muggy Syndrome in Infants

目的:探讨影响婴儿捂热综合征(IMS)预后的相关因素。方法:回顾性调查我院重症监护病房(ICU)近5年收治住院的51例IMS患儿资料,进行单因素χ2检验,再对差异有统计学意义的单因素进行多因素Logistic回归分析。结果:51例IMS患儿中,9例死亡,病死率17.6%。IMS患儿死亡组与存活组之间比较,年龄和性别差异无统计学意义(P>0.05),捂热时长、体温、改良Glasgow昏迷评分(PCIS)、小儿危重病例评分(GCS)、脏器功能障碍数目、pH、乳酸、血浆渗透压、Na+浓度、Ca2+浓度、血糖、白蛋白、肌酸激酶同工酶、脑利钠肽、D-二聚体差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,PCIS≤70分、GCS≤8分、脏器功能障碍数目≥3、血Na+≥150 mmol/L、D-二聚体≥2 mg/L为影响IMS患儿预后的独立危险因素。结论:临床医护人员需充分认识影响IMS患儿预后的危险因素,以期早期识别、合理治疗IMS,降低病死率和改善预后。

Objective： To analyze the prognostic risk factors of muggy syndrome（IMS） in infants.Methods： Clinical data of 51 IMS cases admitted to ICU of our hospital in recent five years were reviewed retrospectively.All the data was analyzed by using chi-square test and multiple Logistic regression analysis.Results： In 51 IMS cases,nine were dead;the case-fatality rate was 17.6%.Age and sex had no significance between the death group and the survival group.Length of muggy period,temperature,PCIS,GCS,number of dysfunction organs,pH,lactic acid,osmotic pressure of plasma,Na＋ concentration,Ca2＋ concentration,Glucose,ALB,CK-MB,BNP,D-dimeride showed significant difference between the two groups（P0.05）.Multiple Logistic regression analysis showed that PCIS≤70,GCS≤8,number of dysfunction organs ≥3,hypernatremia ≥150 mmol/L,D-dimeride ≥2 mg/L were independent risk factors of IMS.Conclusions： Clinical physicians and nurses should recognize the prognostic risk factors of IMS,thus IMS could be recognized early,and treated reasonably.We could reduce the fatality rate and improve the prognosis of IMS.