新生儿脓毒症发生毛细血管渗漏综合征的临床危险因素分析

目的：对新生儿脓毒症发生毛细血管渗漏综合征（CLS）的临床危险因素进行分析。方法对2011年6月～2013年6月在深圳市宝安区人民医院接受治疗的30例新生儿发生脓毒症的临床资料进行回顾性分析。30例患儿中15例为一般脓毒症，10例为严重脓毒症，5例为脓毒性休克；再根据患儿是否发生CLS为准，将患儿分为CLS组与非CSL组；在进行单因素分析时，对患儿的年龄、性别、凝血功能障碍等各种相关因素进行了解，自变量为具有统计学意义的相关指标，进而进行回归分析。结果一般脓毒症、严重脓毒症和脓毒性休克患儿的发生率分别为2/15（13.33%）、4/10（40.00%）、4/5（80.00%），差异有统计学意义（P〈0.01）；严重脓毒症及休克和PRISM评分是脓毒症患者出现CLS 1的独立危险因素。结论新生儿的脓毒症的严重程度与PRISMⅢ评分呈正比关系，患儿PRISI I评分越高发生CLS的概率就越大。对于脓毒症较严重以及PRISI I评分较高的患儿来说，尽早对其血糖、感染标志物等进行检测，对于判断CLS有积极的帮助，并且能够有效降低儿童脓毒症合并CLS的病死率。

Objective To analyze the clinical risk factors for capillary leak syndrome, neonatal sepsis. Methods Clinical data of 30 cases of neonatal sepsis from June 2011 to June 2013 in the hospital for treatment were retrospectively analyzed. 15 cases were general sepsis patients, 10 patients were severe sepsis, five cases were septic shock;then the children were be divided into groups and the number of cases non-CSL group based on whether children had capillary leak syndrome （CLS）;a variety of related factors such as age, gender, coagulation disorders were analyzed, the variable is associated with a statistically significant indicators were done with regression analysis. Results General sepsis, severe sepsis and incidence of septic shock in children were 2/15 （13.33%）, 4/10 （40.00%）, 4/5 （80.00%）, the difference was statistically significant （P〈0.01）;Severe sepsis and shock and PRISM score were independent risk factors for sepsis patients CLS 1. Conclusion The severity of neonatal sepsis and PRISMⅢscore positive correlation between children PRISIII higher the rating, the greater the probability of occurrence of CLS. For more severe sepsis and PRISIII score higher in children who, as soon as possible for a blood infection and other markers are detected positive for judging CLS help, and can effectively reduce child mortality in sepsis with CLS.