PICU危重患儿预后危险因素分析

Analysis of Prognostic Risk Factors in Critically Ill Children with PICU

目的通过对我院近4年来150例PICU危重患儿的病例进行剖析,总结影响预后的相关因素。方法收集150例2014年3月～2018年5月于我院PICU住院治疗危重患儿的临床资料作为研究对象,按预后不同,分为生存组97例和终点事件组53例,对比两组患儿在降钙素原、乳酸脱氢酶、血钙、血乳酸及血pH值水平的差异。结果两组患儿的年龄和性别比较,差异无统计学意义(P>0.05)。生存组患儿降钙素原、乳酸脱氢酶和血乳酸分别为(0.72±0.31)ng/ml、(75.43±28.88)IU/L和(4.71±1.88)mmol/L,均低于终点事件组的(1.98±0.92)ng/ml、(119.2±49.89)IU/L和(8.46±2.98)mmol/L;血钙和血pH值分别为(1.41±0.55)mmol/L和(7.23±0.20),高于终点事件组的(1.13±0.42)mmol/L和(7.05±0.15),差异均具有统计学意义(P<0.05)。结论对于降钙素原、乳酸脱氢酶、血乳酸明显升高,血钙值低和严重酸中毒患儿,生存质量及预后差,死亡风险上升,这些临床指标对PICU危重患儿预后具有重要的临床指导意义。

Objective To analyze the related factors affecting prognosis by analyzing 150 cases of PICU critically ill children in our hospital in the past 4 years.Methods A total of 150 patients with critically ill children who were hospitalized in our hospital from March 2014 to May 2018 were enrolled as the study subjects. According to the prognosis, they were divided into the survival group of 97 cases and the end point group of 53 cases. Differences in procalcitonin, lactate dehydrogenase, serum calcium, blood lactate, and blood pH levels.ResultsThere was no significant difference in age and gender between the two groups （P〉0.05）. Procalcitonin, lactate dehydrogenase and blood lactate in the survival group were （0.72±0.31） ng/ml, （75.43±28.88） lU/L and （4.71 ±1.88） mmol/L, respectively, which were lower than the endpointgroup （1.98±0.92） ng/ml, （119.2±49.89） lU/L and （8.46±2.98） mmol/L; the serum calcium and blood pH values were （1.41±0.55） mmol/L and （7.23±0.20）, respectively, above the endpoint group （1.13 ± 0.42） mmol/L and （7.05±0.15）, the difference was statistically significant （P〈0.05）. Conclusion For procalcitonin, lactate dehydrogenase, blood lactate, blood calcium and severe acidosis, the quality of life and prognosis are poor, and the risk of death increases. These clinical indicators have important clinical guiding significance for the prognosis of critically ill children with PICU.