脓毒症患者的临床特征及死亡相关因素分析

目的：探讨重症监护病房（ICU）脓毒症患者的临床特点及其死亡危险因素。方法回顾分析2012年4月—2014年4月河北医科大学第三医院 ICU 收治的370例脓毒症患者的临床资料，统计分析临床特征，采用 logistic回归分析脓毒症患者死亡的独立危险因素。结果 ICU 脓毒症病死率为46.5%（172/370）；感染部位以呼吸道（59.2%）为主，合并多部位感染者占12.7%；革兰阴性菌为最常见致病菌62.7%（175/279）]。logistic 回归分析显示，年龄、入 ICU 24 h APACHE II 评分、并发脓毒症休克及多脏器功能衰竭为脓毒症患者死亡的独立危险因素（ P ﹤0.05，P ﹤0.01）。结论临床工作中早期识别 ICU 脓毒症高危人群，早期干预，可获得更好的临床预后。

Clinical Features and Risk Factors Associated with Death of Sepsis Patients

Objective To investigate the clinical features and risk factors associated with the death of sepsis pa-tients in invasive care unit(ICU). Methods Clinical data of 370 sepsis patients admitted between April 2012 and April 2014 in the ICU was retrospectively analyzed,and the clinical features were statistically analyzed. Logistic regression a-nalysis was performed to analyze independent risk factors of death for sepsis patients. Results ICU mortality rate was 46. 5%(172 / 370),and the respiratory tract infection was the most common site of infection(59. 2% ),and followed by concurrent infection of multiple sites(12. 7% ). Gram-negative bacteria was the most commonly pathogenic bacteria 62. 7%(175 / 279)]. Logistic regression analysis showed that independent risk factors for sepsis patients were age,a-cute physiology and chronic health evaluation II(APACHE II)score within 24 h upon ICU admission,associated by sep-sis shock and multiple organ failure(P ﹤ 0. 05,P ﹤ 0. 01). Conclusion The early diagnosis and intervention of high-risk groups for sepsis patients in ICU can achieve better clinical prognosis.