儿童脓毒症新发功能障碍的特点

Features of new-onset organ dysfunction in children with sepsis

目的 探讨儿科重症监护病房脓毒症患儿新发功能障碍的特点。方法 回顾性分析2015~2016年入住儿科重症监护病房的脓毒症患儿的临床资料。比较重度脓毒症(34例)与非重度脓毒症(69例)患儿新发功能障碍发生率和入院、出院功能状态及其变化。结果 重度脓毒症组新发功能障碍发生率显著高于非重度脓毒症组(38%vs6%,P<0.05)。非重度脓毒症组入院功能状态相对良好,出院总体功能状态较入院时改善。重度脓毒症组入院功能状态较差,出院时神志、感觉、沟通、呼吸功能状态处于轻、中度异常状态。结论 非重度脓毒症患儿新发功能障碍率低,预后较好。重度脓毒症患儿新发功能障碍发生率高,预后较差。

Objective To study the features of new-onset organ dysfunction in children with sepsis in the pediatric intensive care unit (PICU). Methods A retrospective analysis was performed for the clinical data of children with sepsis who were admitted to the PICU from 2015 to 2016. There were 34 children with severe sepsis and 69 with non-severe sepsis, and the two groups were compared in terms of the incidence rate of new-onset organ dysfunction and the functional status on admission and at discharge. Results The severe sepsis group had a significantly higher incidence rate of new-onset organ dysfunction than the non-severe sepsis group (38% vs 6%;P<0.05). The children in the non-severe sepsis group had a relatively good functional status on admission, with marked improvement in the overall functional status at discharge. The children in the severe sepsis group had a poor functional status on admission, with mild/moderate abnormalities in consciousness, sensation, communication and respiratory function at discharge. Conclusions Children with non-severe sepsis have a low incidence rate of new-onset organ dysfunction and a good prognosis, and those with severe sepsis often have a high incidence rate of new-onset organ dysfunction and a poor prognosis.