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目的 分析儿科ICU(PICU)白血病休克病例的发生特点和转归。方法 对 47例合并休克患儿进行回顾性分析 ,并对 7例患儿测定了血浆肿瘤坏死因子 (TNF -α)、白介素 - 6 (IL - 6 )、IL - 10。结果 47例患儿占同期PICU内休克病例的 2 0 .8% ,死亡 32例 ,病死率 6 8.1%。起始休克类型 :感染性休克 18例、低血容量性休克 8例、中毒性休克 3例、“神经 -心源性休克”6例、“混合性休克”12例。休克前均存在多脏器损害 ,感染、药物细胞毒性是重要诱发因素。所测TNF -α、IL - 10均明显增高。血培养阳性率 5 8.9%。结论 本组均符合亚急性 -复杂型休克特点及预后。对脏器低灌注和失控炎症 -免疫反应的监测可能有助于防止和早期发现休克。
Objective To analyze the characteristics and outcome of pediatric ICU (PICU) leukemia shock cases. Methods A total of 47 children with shock were retrospectively analyzed. Plasma tumor necrosis factor (TNF - α), interleukin - 6 (IL - 6) and interleukin - 10 (IL - 10) were measured in 7 children. Results 47 cases of children accounted for 20.8% of PICU shock cases in the same period, 32 cases died, the fatality rate was 6 8.1%. The initial shock type: septic shock in 18 cases, hypovolemic shock in 8 cases, toxic shock in 3 cases, “neuro-cardiogenic shock” in 6 cases, “mixed shock” in 12 cases. Shock before multiple organ damage, infection, drug cytotoxicity is an important predisposing factor. The measured TNF-α, IL-10 were significantly higher. Blood culture positive rate of 5 8.9%. Conclusion This group are in line with subacute - complex characteristics and prognosis of shock. Hypoperfusion and uncontrolled inflammation of organs - Monitoring of the immune response may help prevent and early detection of shock.