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目的探讨小儿脓毒症的临床特点及救治体会。方法对深圳市宝安区妇幼保健院儿科重症监护中心(PICU)2010年1月-2012年6月收治的145例脓毒症患儿进行回顾性分析,将145例患儿按照细菌培养结果分为2组。结果发现36例脓毒症患儿细菌学检测结果阳性,109例脓毒症患儿未证实有细菌学阳性。细菌所致脓毒症(细菌学检测结果阳性)患儿血WBC、CRP、PCT明显高于细菌学检测结果阴性脓毒症组(P<0.05),非细菌感染所致脓毒症组CK-MB高于细菌所致脓毒症组(P<0.05);两组患儿的血清游离钙水平差异无统计学意义(P>0.05)。结论细菌学检测结果阳性脓毒症组患儿的血WBC、CRP、PCT明显高于细菌学检测结果阴性脓毒症组,细菌学检测结果阴性的脓毒症组CK-MB、α-HBD明显高于细菌学检测结果阳性脓毒症组,两组患儿血清游离钙水平差异无统计学意义。两组患儿死亡率无明显差异。对于脓毒症患儿的救治,关键在于早期识别脓毒症,特别是早期识别脓毒性休克,积极进行恰当而有效的液体复苏,有效地控制感染等综合性治疗措施,并在治疗过程中动态评估、处理、再评估、再处理,对提高脓毒症患儿的抢救成功率,具有重大意义。
Objective To investigate the clinical features and treatment of pediatric sepsis. Methods A retrospective analysis was performed on 145 children with sepsis admitted to the Department of Pediatric Intensive Care (PICU) in Bao’an District, Shenzhen from January 2010 to June 2012. 145 children were divided according to the result of bacterial culture 2 teams. The results showed that 36 cases of sepsis in children with positive bacteriological tests, 109 cases of sepsis did not confirm the bacteriological positive children. Bacterial sepsis (bacteriological test results positive) children with blood WBC, CRP, PCT was significantly higher than the bacteriological test negative sepsis group (P <0.05), non-bacterial infection caused by sepsis group CK- MB was higher than that of bacterial-induced sepsis (P <0.05). There was no significant difference in serum free calcium between the two groups (P> 0.05). Conclusions The blood WBC, CRP and PCT in children with positive sepsis test were significantly higher than those with bacteriological test negative sepsis. The CK-MB and α-HBD in bacteriological test-negative sepsis group were significantly higher Higher than bacteriological test positive sepsis group, serum calcium levels in two groups had no significant difference. There was no significant difference in mortality between the two groups. For the treatment of children with sepsis, the key lies in the early identification of sepsis, especially early recognition of septic shock, active and proper liquid resuscitation, effective control of infection and other comprehensive treatment measures, and in the course of the treatment of dynamic Evaluation, treatment, re-evaluation, reprocessing, to improve the success rate of rescue rescue children with sepsis, of great significance.