摘要
目的探讨急诊病房患者脓毒症患病现状，并对其病原菌进行分析。方法收集2004年1月至2006年12月急诊病房患者病例资料，调查分析脓毒症患病情况及病原菌，行Chi—Square检验。结果三年间出院6949人，符合脓毒症诊断标准260例，年患病率为3．4％、3．7％、4．1％。死亡118例，病死率45．4％，年病死率为49．3％、46．4％、41．9％。严重脓毒症159例，病死率60．4％（96／159）；MODS101例，病死率73．3％（74／101）；脓毒性休克73例，病死率84．9％（62／73）；脏器功能障碍多于3个46例，病死率91．3％（42／46）。患病率和病死率在≥60岁组（4．0％、47．3％）高于〈60岁组（2．2％、23．8％，P〈0．05），男性与女性间差异无统计学意义。原发感染部位主要为下呼吸道感染45．8％，皮肤感染18．5％，消化道感染15．8％，泌尿道感染15．0％。院内感染相关脓毒症27．3％。分离病原菌201株，其中G^-菌99株（49．3％）、G^＋菌43株（21．4％），真菌59株（29．4％）。结论急诊病房有较高的脓毒症患病率和病死率，G^-菌和真菌为主要致病菌，故应重视脓毒症致病菌防治。
Objective To investigate the morbidity and pathogens of sepsis-hospitalization patients in Emergency Medicine Department （EMD）. Method The clinical data of sepsis patients were retrospectively analyzed during the period from 2004 to 2006 in EMD and Chi-Square test was used. Results A total of 6949 patients were discharged in the EMD over the 3-year period, and 260 were sepsis. The annual morbidity of the sepsis of the three years was 3.4%, 3.7%, 4.1%, respectively. The number of sepsis-related death was 118 （45.4）%. The annual mortality of the sepsis was 49.3%, 46.4%, 41.9%. A total of 159 patients had severe sepsis and the mortality rate was 60.4% （96 /159）. The sepsis with multiple organ dysfunction syndrome （MODS） was in 101 patients and the mortality was 73.3% （74/101）. The septic shock was in 73 patients and the mortality was 84.9% （62/73）. The mortality was 91.3% among 46 patients with more than three dysfunction organs . The morbidity and mortality of sepsis in patients ≥60 years old （4.0 % and 47.3% ） were higher than inthose 〈 60 years old （2.2 %, 23.8%, P 〈 0.05）. The morbidity and mortality of sepsis was not signifificantly different between men （3.9%, 47.6%） and women （3.6%, 42.5%, P〉0.05）. The infection of low respiratory tract （45.8%）, skin （18.5%）, alimentary （15.8%） and urinary tract （15.0%） were the most common infection site of sepsis. The morbidity of hospital-infection related sepsis was 27.3%. The pathogens obtained from the sepsis patients were 201 strains, the gram＇negative bacteria was 49.3%, gram-pesitive bacteria 21.4%, and fungal organism 29.3%. Conclusions The morbidity of sepsis and the number of sepsis-related death was still very high, and gram-negative bacteria and fungal organisms the most common pathogens.
出处
《中华急诊医学杂志》
CAS
CSCD
2007年第7期745-748,共4页
Chinese Journal of Emergency Medicine
关键词
脓毒症
患病率
病死率
致病菌
Sepsis
Morbidity
Mortality rate
Pathogens
