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[关于儿童感染性休克的临床特征和病原性组成的多中心回顾性研究]
1Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
Zhonghua er ke za zhi = Chinese journal of pediatrics
|October 21, 2024
概括
中国的儿科败血症休克主要是细菌性,病毒性影响很大. 恶性瘤,高PRISM III和pSOFA分数是儿童死亡的独立风险因素.
科学领域:
- 儿科重症监护室的儿童重症监护室
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 感染性休克是儿童的危及生命的疾病,需要密集护理和了解其流行病学和风险因素.
- 之前的研究已经强调了管理儿科败血症休克的挑战,特别是关于病原体的流行和患者的结果.
- 识别特定的风险因素和常见的病原体对于改善儿科重症监护室 (PICU) 的治疗策略和生存率至关重要.
研究的目的:
- 研究中国PICU中儿科败血症休克的临床特征,常见的病原体和预后.
- 确定与性休克儿童死亡相关的独立风险因素.
- 为了比较患有恶性瘤和没有恶性瘤的儿童之间的结果.
主要方法:
- 一项多中心的回顾性队列研究,涉及来自中国10家医院的1,247名患有感染性休克的儿童 (2018-2021).
- 收集的数据包括临床特征,病原体识别和患者结果.
- 统计分析包括t测试,曼·惠特尼U测试,Chi平方测试和多重后勤回归来确定死亡风险因素.
主要成果:
- 整体住院死亡率为23.2%. 细菌感染占主导地位 (61.4%),其次是病毒感染 (24.8%).
- 常见的细菌病原体包括格拉姆阴性细菌 (Pseudomonas aeruginosa,Enterobacter) 和格拉姆阳性细菌 (Streptococcus,Staphylococcus).
- 与没有瘤的儿童相比,患有恶性瘤的儿童的严重性得分更高 (PRISM III,pSOFA),病原体阳性率更高,住院死亡率明显更高 (29.7%).
结论:
- 细菌感染是中国儿科败血症休克的主要原因,尽管病毒感染也很重要.
- 恶性瘤与更严重的疾病和儿科败血症休克病例中更高的资源消耗有关.
- 儿科败血性休克的高死亡率仍然存在,恶性瘤,PRISM III和pSOFA评分被确定为死亡的独立风险因素.
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