急性感染致全身炎症反应综合征367例临床分析

Systemic inflammatory response syndrome due to acute infection:clinical analysis of 367 cases

目的 :分析急性感染致全身炎症反应综合征 (SIRS)的临床特征 ,提高对 SIRS的认识水平。方法 :按美国胸科医师学会和危重医学学会 (ACCP/ SCCM)的 SIRS诊断标准分析感染性 SIRS 367例的临床资料。结果 :感染性 SIRS 367例中符合 2项标准者 1 4 4例 ,符合 3项标准者 1 35例 ,3项以上者 93例 ,并发多器官功能障碍综合征 (MODS) 93例 ,死亡 63例 ;随着符合 SIRS标准的项数增加 ,并发功能障碍的脏器增多 ,病死率升高。 88.2 % MODS患者表现为双相迟发型发病过程。革兰阴性杆菌引起的 SIRS的病死率高于革兰阳性球菌引起的SIRS;糖发质激素治疗不能降低 SIRS的病死率 ,感染菌对泰能有较高的敏感率。结论 :临床医生必须重视 SIRS。

Objective:To analyze the clinical characteristic of systemic inflammatory response syndrome(SIRS)caused by acute infection Methods:Three hundred and sixty seven patients with SIRS due to acute infection were analyzed retrospectively The diagnosis of SIRS was made according to ACCP/SCCM criteria Results:The subjects who met 2,3 or 4 items of ACCP/SCCM criteria were 144,135 and 93,respectively Ninety three cases developed multiple organ dysfunction syndrome(MODS),and 63 cases died of MODS The incidence of dysfunctional organ and the mortality of patients increased with the item growth of ACCP/SCCM criteria The mortality of patients infected with gram negative bacilli was superior to that with gram positive cocci Glucocorticoid administration showed no obvious improvement of the patients' prognosis Tienem was an effective antibiotics for treating bacterial infection Conclusion:Clinicians should pay great attention to the diagnosis,prophylaxis and treatment of SIRS and MODS