外科重症监护室645例脓毒症患者临床流行病学调查

目的了解脓毒症在外科重症监护室（SICU）的发生情况。方法收集2003年1月～2004年12月上海市中西医结合医院SICU入住病例645例，统计全身炎症反应综合征（SIRS）、脓毒症、严重脓毒症和脓毒性休克的发生率、病死率及其与年龄、性别的关系，以及在住院时间上的差异。结果术后第1日SIRS的发生率为63．7％。术后第2日为49．8‰，在SICU期间SIRS发生率为74．3％；未发生SIRS组无死亡病例，发生SIRS组病死率为6．26％。脓毒症发生率为27．0％，严重脓毒症为10．9％，脓毒性休克为7．0％；其病死率分别为14．94％、34．29％和51．11％。脓毒症和非脓毒症患者在年龄上存在差异（P〈0．01），老年人更易发生；在性别上存在差异（P〈0．01）．男性比女性更易发生。在住院时间上脓毒症和非脓毒症患者间差异有显著性（P〈0．01）。结论脓毒症在SICU较为常见，有高龄、男性易发生的特点，严重影响患者预后；须重视明确定义，提高治疗效应。

Investigation on epidemiology in 645 cases with sepsis in surgical intensive care unit

Objective To investigate the epidemiology of sepsis in surgical intensive care unit.(Methods) The clinical data of 645 intensive care unit cases,admitted during January 2003 to December 2004 in Shanghai Integrated Traditional Chinese and Western Medicine Hospital,were analyzed.The incidence and mortality of systemic inflammatory response syndrome(SIRS),sepsis,severe sepsis and septic shock,as well as the relationship between them,and age,sex were studied.The hospital stay time was compared(among) the patients with sepsis,severe sepsis,septic shock and the patients without sepsis.Results The(incidence) of SIRS at the first day and second day in surgical intensive care unit was 63.7% and 49.8%(respectively,while 74.3%) of the cases developed SIRS in surgical intensive care unit.There was no death in nonSIRS group,while the mortality was 6.26% in SIRS group.The incidences of sepsis,severe sepsis,septic shock were 27.0%,10.9%,7.0% respectively,and their mortality was 14.94%,34.29%,51.11% respectively.The elderly and the male had more chance to develop sepsis(both P<0.01).The sepsis group stayed longer in surgical intensive care unit than nonsepsis group(P<0.01).Conclusion Sepsis is not uncommon in surgical intensive care unit and elderly and male are more susceptible to develop it and carry a poor prognosis.More attention should be given to sepsis in surgical intensive care unit.