中国实用儿科杂志2017，Vol.32Issue(5)：353-356,4.DOI:10.19538/j.ek2017050609
恶性血液肿瘤患儿合并脓毒性休克死亡危险因素分析
Risk factors for mortality of septic shock in pediatric patients with hematological malignancies
刘婷华 1汤昔康 1陈泽楷 1雷嘉颖 1许吕宏 1李天文 1麦友刚1
作者信息
- 1. 中山大学孙逸仙纪念医院PICU,广东广州510120
- 折叠
摘要
Abstract
Objective To study clinical characteristics and risk factors for mortality of septic shock patients with hematological malignancies in pediatric intensive care unit (PICU).Methods A retrospective analysis of records of pediatric patients with hematological malignancy and septic shock was performed.In our study,43 cases admitted to PICU in Sun Yat-sen Memorial Hospital between March 2012 and September 2015 were included.Results Among the 43 cases,16 died,while the other 27 survived.The percentage of mortality was 37.2％.Pulmonary infection (74.4％) and gastrointestinal tract infection (39.5％) were the common causes of septic shock in these patients.Etiological examination revealed 43 kinds of pathogenic bacteria in 26 cases.The percentage of gram-positive bacteria,gram-negative bacteria and fungus was 11.6％,72.1％ and 16.3％,respectively.Escherichia coli was found to be the main pathogen (6/43,14.0％).Between the survival group and the mortality group,there were significant differences in the parameters of age,chemotherapy courses,time from infection to shock,time from neutropenia to shock,multiple organs dysfunction,pulmonary infection,hypocalcemia,oxygenation index and serum lactic acid concentration after 6 hours of fluid resuscitation,requirement of dopamine and mechanical ventilation (P ＜ 0.05).By logistic regression analysis,mortality was associated with the variables of serum lactic acid concentration after 6 hours of fluid resuscitation and requirement of mechanical ventilation.Conclusion The risk factors for mortality of septic shock in pediatric patients with hematological malignancies are hyperlactacidemia after 6 hours of fluid resuscitation,hypocalcemia and requirement of mechanical ventilation.关键词
儿童/血液肿瘤/脓毒性休克/危险因素Key words
child/hematological malignancy/septic shock/risk factors分类
医药卫生引用本文复制引用
刘婷华,汤昔康,陈泽楷,雷嘉颖,许吕宏,李天文,麦友刚..恶性血液肿瘤患儿合并脓毒性休克死亡危险因素分析[J].中国实用儿科杂志,2017,32(5):353-356,4.
