脓毒症患者诊治现状

Diagnosis and Treatment Status of Sepsis Patients

目的调查大型综合医院重症医学科(intensive care unit,ICU)收治的脓毒症患者的诊治情况。方法采用前瞻性队列研究二次分析方法,调查了2020年3月1日~2023年12月31日北京协和医院ICU收治的重症感染患者,并对符合脓毒症诊断标准的患者进行了分析。结果在34个月内,ICU共收治重症感染患者11663例,其中脓毒症患者为4430例,占ICU总收治患者的38.0%。脓毒症患者以外科术后患者为主,肺和腹腔是最常见感染灶。脓毒症患者院内病死138例,放弃治疗/签字拒绝抢救后28天内预期病死78例,总28天病死率为4.9%(216/4430)。结论脓毒症是入住ICU的常见原因,在ICU患者中具有较高的发生率。本研究揭示了大型综合医院ICU重症感染患者脓毒症发生现状及病原学特点。对于脓毒症患者,应积极采取治疗措施,以提高患者的生存率。

Objective To investigate the diagnosis and treatment status of sepsis patients admitted to the intensive care unit(ICU)of a large comprehensive hospital.Methods The secondary analysis method of prospective cohort study was conducted to investigate the patients with severe infection admitted to the ICU of Peking Union Medical College Hospital from March 1st 2020 to December 31st 2023,and the patients meeting the diagnostic criteria for sepsis were analyzed.Results For 34months,a total of 11663 patients with severe infection were admitted to the ICU,among whom 4430 patients were diagnosed with sepsis,accounting for 38.0% of the total number of ICU patients.Most sepsis patients were postoperative,and the lung and abdominal cavity were the most common sites of infection.Among the sepsis patients,138 patients died in hospital,and 78 patients were expected to die within 28days after giving up treatment/signing do not resuscitation,with totally 28-day mortality rate of 4.9%(216/4430).Conclusion Sepsis is a common cause of admission to the ICU,with a high incidence rate among ICU patients.This study revealed the current situation and etiological characteristics of sepsis patients in ICU patients with severe infection in large comprehensive hospital.For patients with sepsis,active treatment measures should be taken to improve the survival rate of patients.