综合ICU内腹腔感染相关性脓毒症患者的临床特征分析

Analysis of Clinical Characteristics of Patients with Sepsis Associated with Abdominal Infection in Comprehensive ICU

目的观察分析综合ICU(重症监护室)内腹腔感染相关性脓毒症患者的临床特征。方法选取该院在2018年4月—2019年4月收治的53例腹腔感染相关性脓毒症患者作为研究组,再选取同期该院收治的53例腹腔感染相关性非脓毒症患者作为对照组。采用统计学分析两组研究对象的病死率、平均住院费用、临床特征(白蛋白小于200 mg/L、非结肠性来源感染、首次抗生素未能覆盖致病菌、急性肾功能损伤、耐药菌感染、感染源控制措施延迟等)。结果研究组病死率、平均住院费用分别为52.8%(28/53)、(0.98±0.21)万元/d,对照组分别为11.3%(6/53)、(0.55±0.14)万元/d,研究组病死率、平均住院费用明显高于对照组,差异有统计学意义(χ^(2)=20.958,t=15.234,P<0.05);两组研究对象在非结肠性来源感染、首次抗生素未能覆盖致病菌、耐药菌感染所占比比较差异无统计学意义(χ^(2)=0.000、0.064、0.059,P=1.000、0.800、0.807),研究组白蛋白小于200 mg/L、急性肾功能损伤、感染源控制措施延迟所占比明显高于对照组,差异有统计学意义(χ^(2)=16.458、18.806、25.364,P<0.05)。结论综合ICU内腹腔感染相关性脓毒症患者的病死率高且住院费用多,需积极纠正腹腔感染相关性脓毒症患者的白蛋白血症,采取针对性感染源控制措施。

Objective To observe and analyze the clinical characteristics of patients with sepsis associated with abdominal infection in a comprehensive ICU(intensive care unit).Methods 53 patients with abdominal cavity infection-related sepsis admitted to the hospital from April 2018 to April 2019 were selected as the study group,and 53 patients with abdominal cavity infection-related non-sepsis admitted to the hospital during the same period were selected as the control group.Statistics were used to analyze the mortality,average hospitalization expenses,and clinical characteristics of the two groups of subjects(albumin less than 200 mg/L,infections from non-colonal origin,failure to cover pathogenic bacteria with first antibiotics,acute kidney injury,and infections with drug-resistant bacteria delays in infection control measures,etc.).Results The mortality and average hospitalization expenses in the study group were 52.8%(28/53)and(0.98±0.21)ten thousand yuan/d,respectively,and 11.3%(6/53)and(0.55±0.14)ten thousand yuan/d in the control group,the mortality rate,average hospitalization expense of the study group was significantly higher than that of the control group,and the difference was statistically significant(χ^(2)=20.958,t=15.234,P<0.05).There was no statistically significant difference in the proportion of non-colonal source infections,the proportion of pathogenic bacteria that were not covered by antibiotics for the first time,and the proportion of drug-resistant bacterial infections(χ^(2)=0.000,0.064,0.059,P=1.000,0.800,0.807>0.05),the proportion of albumin less than 200 mg/L in the experimental group,the proportion of acute renal damage,and the proportion of delay in infection control measures were significantly higher than those in the control group,and the difference was statistically significant(χ^(2)=16.458,18.806,25.364,P<0.05).Conclusion In the comprehensive ICU,patients with abdominal infection-related sepsis have a high mortality rate and high hospitalization costs.It is necessary to actively correct the albuminemia of patients with abdominal infection-related sepsis and take targeted infection source control measures.