中国中医急症2026，Vol.35Issue(1)：42-46,51,6.DOI:10.3969/j.issn.1004-745X.2026.01.009
ICU肺炎克雷伯菌血流感染中西医临床特点及预后危险因素分析
Analysis of Clinical Characteristics and Prognostic Risk Factors of Integrated Traditional Chinese and Western Medicine for Klebsiella Pneumoniae Bloodstream Infection in ICU
摘要
Abstract
Objective:To explore the clinical characteristics and risk factors of integrated traditional Chinese and western medicine for short-term death in ICU patients with Klebsiella pneumoniae bloodstream infection.Methods:A retrospective analysis was conducted on the clinical data of 37 patients with Klebsiella pneumoniae bloodstream infection admitted to the Department of Critical Care Medicine,Beijing Hospital of Traditional Chi-nese Medicine Affiliated to Capital Medical University from May 2017 to January 2025.According to the survival status 28 days after the initiation of treatment,the patients were divided into a death group(19 cases)and a surviv-al group(18 cases).The integrated traditional Chinese and western medicine clinical characteristics of the patients were analyzed,and Cox regression analysis was used to identify the independent risk factors for death.Results:The age of the patients ranged from 53 to 94 years old,all of whom had underlying diseases.The main sources of bloodstream infection were lower respiratory tract infection and urinary tract infection.Compared with the survival group,the death group had higher APACHE Ⅱ scores and SOFA scores,a higher proportion of patients receiving invasive mechanical ventilation and suffering from septic shock,and a longer time from ICU admission to onset(P＜0.05).In terms of traditional Chinese medicine(TCM)syndrome differentiation,83.8％of the patients were di-agnosed with syndrome of flaring heat in qifen and yingfen.The death group had a higher incidence of altered mental status and cold extremities than the survival group(P＜0.05).Multivariate analysis showed that elevated APACHE Ⅱ score and altered mental status were independent risk factors for 28 days death in ICU patients with Klebsiella pneumoniae bloodstream infection.Conclusion:Most ICU patients with Klebsiella pneumoniae blood-stream infection are diagnosed with syndrome of flaring heat in qifen and yingfen in TCM.Septic shock,elevated SOFA score,invasive mechanical ventilation,altered mental status and cold extremities are all associated with the prognosis of the disease.Elevated APACHE Ⅱ score and altered mental status at the onset of Klebsiella pneumoni-ae bloodstream infection in ICU are independent risk factors for prognosis.关键词
血流感染/肺炎克雷伯菌/重症监护室/中西医/气营两燔Key words
Bloodstream infection/Klebsiella pneumoniae/Intensive care unit/Integrated traditional Chinese and western medicine/Syndrome of flaring heat in qifen and yingfen分类
医药卫生引用本文复制引用
张鑫,杨思雯,张羽,陈腾飞..ICU肺炎克雷伯菌血流感染中西医临床特点及预后危险因素分析[J].中国中医急症,2026,35(1):42-46,51,6.基金项目
北京市属医院科研培育计划(PZ2023011) （PZ2023011）
