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目的 :分析急诊脓毒症的流行病学特点、临床特征及预后影响因素。方法 :收集2014年9月至2016年4月期间我院经急诊收治的脓毒症病例191例,统计性别、年龄、基础疾病、住院时间、预后、感染部位、器官功能障碍情况、血培养结果、序贯器官衰竭估计(SOFA)评分等数据,并作预后分析。结果:191例脓毒症患者中脓毒症85例(44.5%),严重脓毒症72例(37.7%),脓毒症休克34例(17.8%)。95例(49.7%)为男性。平均年龄(68.95±18.16)岁。老年患者(>60岁以上)占71.2%。最常见的基础疾病是糖尿病,平均住院天数(14.89±9.65)d,死亡33例(17.3%),最常见感染部位在呼吸系统,器官功能障碍数大于1个的患者51例(26.7%),血培养阳性率20.4%,中位SOFA评分2分。死亡患者与存活患者在SOFA评分、器官功能障碍数、疾病严重程度上有统计学差异(均P<0.05)。结论 :急诊脓毒症有高龄、合并基础疾病率高、易并发脏器功能障碍的特点。SOFA评分可有效评估脓毒症的严重程度及预后。
Objective: To analyze the epidemiological characteristics, clinical characteristics and prognostic factors of emergency sepsis. Methods: A total of 191 cases of sepsis admitted to our hospital from September 2014 to April 2016 were collected. The data of sex, age, underlying disease, hospital stay, prognosis, site of infection, organ dysfunction, blood culture results , Sequential organ failure estimation (SOFA) score and other data, and for prognostic analysis. RESULTS: Sepsis in 85 of 191 (44.5%) sepsis patients, sepsis in 72 sepsis (37.7%) and septic shock in 34 (17.8%) sepsis patients. 95 cases (49.7%) were male. The average age (68.95 ± 18.16) years old. Elderly patients (> 60 years of age or older) accounted for 71.2%. The most common underlying diseases were diabetes mellitus, with an average length of stay of 14.89 ± 9.65 days and 33 deaths (17.3%). Of the 51 patients (26.7%) with the most common infection sites in the respiratory system and more than one organ dysfunction, Blood culture positive rate of 20.4%, the median SOFA score of 2 points. There was a significant difference in the SOFA score, the number of organ dysfunction and the severity of the disease among the patients who died and those who survived (all P <0.05). Conclusions: Emergency sepsis has the characteristics of advanced age, combined with the high rate of underlying diseases, easy to complicated organ dysfunction. SOFA score can effectively assess the severity and prognosis of sepsis.