恶性疟疾所致脓毒症的临床特征分析

目的分析恶性疟疾并发脓毒症的临床特征。方法对我院近8年来收治的32例确诊为恶性疟疾的患者进行病例资料分析。结果出现脓毒症者26例（81．25％），其中严重脓毒症19例（59．38％），脓毒症休克2例（6．25％）。26例脓毒症常见表现为发热26例（100％）、心率大于90次／min25例（96．15％）以及白细胞数改变23例（88．46％），其他依次为气促、高血糖、C反应蛋白增高。严重脓毒症合并器官功能障碍依次为血液系统损害、肾功能损害、高胆红素血症、意识状态改变、低氧血症、腹胀以及低血压。31例（96．88％）患者治愈或好转出院，1例死亡（3．13％），死亡病例为脓毒症休克患者。结论恶性疟疾原虫感染较易发生脓毒症，并极易发展为严重脓毒症，疟疾所致的严重脓毒症以血液系统损害、肾脏损害、高胆红素血症以及意识状态改变多见，如果发展为脓毒症休克则预后差。该病对青蒿琥酯的治疗效果好，及时使用青蒿琥酯清除疟原虫是预防脓毒症发生的关键。

Clinical Characteristics Analysis of Sepsis Caused by Pernicious Malaria Disease

Objective To investigate the clinical characteristics of the pernicious malaria patients complicated with sepsis. Methods The clinical data of 32 patients with pernicious malaria disease in the recent eight yeats of our hospital were retrospectively analyzed. Results In 32 cases of pernicious malaria patients, sepsis developed in 26 cases. Among the cases with sepsis, the severe sepsis developed in 19 cases, and the shock sepsis developed in 2 cases. Among the severe sepsis with multiple organ dysfunction, blood system was the most frequently involved organ, followed by kidney, liver, brain, the lowed albumin and arterial oxygen pressure. 31 cases were cured, one patient died of the shock sepsis. Conclusion The Plasmodium falciparum malaria cases are easy complicate with sepsis, and easy develop to severe sepsis. Artemisinine is highly effective for treatment of Plasmodium falciparum malaria. Starting treatment with artermisinine is the key to prevent the sepsis in malaria cases.