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目的:研究脓毒性脑病(SE)和无脑病者(NE)的预警因素。方法:分析我院 ICU 2004.1-2006.9 收治的 117 例脓毒症病人的临床资料及相关检查结果,对比分析两组病人的住院时间、病死率、血培养、血压、白细胞计数(WBC)、血小板计数(PLT)、K +、Ca2+、游离钙(iCa2+)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、白蛋白、球蛋白、总胆红素(TBIL)、直接胆红素(DBIL)、肌酐(SCr)、尿素氮(BUN) 、C 反应蛋白(CRP) 、血糖(BS) 、胆固醇、甘油三脂(TG) 、PaCO 2、CT/M RI、A PA CH EⅡ评分的差别。结果:52 例 SE 患者的A PA CH EⅡ评分、病死率、血培养阳性率、 A LT、A ST、SCr、BU N 、PaCO 2 与 65 例 N E 比较差异有统计学意义( P<0.05);鲍曼不动杆菌和金黄色葡萄球菌为脓毒症病人感染率最高的革兰阳性菌和阴性菌,分别为 18.49 % 和 13.70 % ,两组感染病原菌和感染率均不一样;10 例 SE 患者头部 CT/M RI有微小脓肿和组织水肿等阳性表现, 而 N E 组均无阳性表现;A PA CH EⅡ评分与脓毒症的病死率相关, 相关系数为 r=0.541, 而且两组病人 A PA CH EⅡ评分不同, 病死率也不一样,21-25 分段 SE 组病死率要高于 N E 组( P=0.001) 。结论:A PA CH EⅡ评分、血培养、A LT、A ST、SCr、BU N 、PaCO 2 对诊断和鉴别诊断 SE 具有重要意义, 调整 BS、SCr、A LT、BU N 、iCa2+、白蛋白水平对预防脓毒症发生 SE 有益。
Objective: To study the early warning factors of septic encephalopathy (SE) and anencephaly (NE). Methods: The clinical data of 117 sepsis patients admitted to our hospital from January 2004 to June 2006 were analyzed. The hospitalization time, mortality, blood culture, blood pressure, white blood cell count (WBC), platelet count PLT, K +, Ca2 +, iCa2 +, ALT, AST, albumin, globulin, total bilirubin (TBIL), direct bilirubin Creatinine (SCr), blood urea nitrogen (BUN), C-reactive protein (CRP), blood glucose (BS), cholesterol, triglyceride (TG), PaCO 2, CT / M RI, Results: A PA CH E Ⅱ score, case fatality rate, blood culture positive rate, A LT, A ST, SCr, BU N and PaCO 2 in 52 patients with SE were significantly different from 65 patients with NE (P <0.05). Acinetobacter baumannii and Staphylococcus aureus were the most common gram-positive and -negative bacteria in sepsis patients, accounting for 18.49% and 13.70%, respectively. The infection rates of both pathogenic bacteria and infection were different in 10 cases of SE patients Head CT / M RI showed slight abscess and edema and other positive, but no positive results in NE group; A PA CH E Ⅱ score and mortality of sepsis was correlated with a correlation coefficient of r = 0.541, and two groups of patients A PA CH E Ⅱ score, mortality is not the same, 21-25 segment SE group mortality was higher than the NE group (P = 0.001). CONCLUSION: A PA CH EⅡ score, blood culture, A LT, A ST, SCr, BU N and PaCO 2 are important for the diagnosis and differential diagnosis of SE. The levels of BS, SCr, A LT, BU N, iCa2 + and albumin SE to prevent the occurrence of sepsis benefit.