CAJ | 학술논문

目的探讨综合重症监护病房(ICU)多重耐药(multi-drug resistant,MDR)鲍曼不动杆菌(Acinetobacter baumannii,Ab)感染脓毒症患者的临床特征和危险因素.方法回顾分析2009年7月至2013年3月我院综合ICU入住脓毒症患者856例,通过比较多重耐药Ab感染脓毒症患者179例(病例组)与非多重耐药Ab感染脓毒症患者677例(对照组)的临床资料,探讨两组患者的病死率、住院费用、器官功能损害情况和死亡的危险因素.结果多重耐药Ab感染脓毒症患者病死率、48 h病死率及住院费用较对照组高(P＜0.05);多重耐药Ab感染脓毒症患者较对照组更易发生感染性休克、急性肾损伤和骨髓抑制;多重耐药Ab感染脓毒症患者如果APECHEⅡ评分＞25分、24 h内出现多脏器功能障碍综合征(MODS)、感染性休克,则其死亡风险更高(P＜0.05).结论多重耐药Ab感染脓毒症患者具有病死率高、治疗费用昂贵等特征,及时发现患者的死亡危险因素并进行针对性干预极其重要.
목적 탐토종합중증감호병방(ICU)다중내약(multi-drug resistant,MDR)포만불동간균(Acinetobacter baumannii,Ab)감염농독증환자적림상특정화위험인소.방법 회고분석2009년7월지2013년3월아원종합ICU입주농독증환자856례,통과비교다중내약Ab감염농독증환자179례(병례조)여비다중내약Ab감염농독증환자677례(대조조)적림상자료,탐토량조환자적병사솔、주원비용、기관공능손해정황화사망적위험인소.결과 다중내약Ab감염농독증환자병사솔、48 h병사솔급주원비용교대조조고(P＜0.05);다중내약Ab감염농독증환자교대조조경역발생감염성휴극、급성신손상화골수억제;다중내약Ab감염농독증환자여과APECHEⅡ평분＞25분、24 h내출현다장기공능장애종합정(MODS)、감염성휴극,칙기사망풍험경고(P＜0.05).결론 다중내약Ab감염농독증환자구유병사솔고、치료비용앙귀등특정,급시발현환자적사망위험인소병진행침대성간예겁기중요.
Objective To investigate the clinical characteristics and risk factors of multi-drug resistant (MDR) acinetobacter baumannii (Ab) infection in patients with sepsis in ICU.Methods Retrospectively analyzed clinical data of 856 cases of sepsis admitted in ICU of our hospital from July 2009 to March 2013,who were divided into MDR Ab related sepsis group (179 cases) and non-MDR Ab related sepsis group (control group,677 cases).Mortality rate,hospitalization expenses,organ function injury level and risk factors of death were compared between two groups.Results Mortality rate,48 hours mortality rate and hospitalization cost of MDR Ab related sepsis group were higher than those of control group (P ＜ 0.05).Septic shock,acute kidney injury and bone marrow suppression more likely occurred in MDR Ab related sepsis group (P ＜ 0.05).APACHE Ⅱ score ＞ 25,septic shock and multiple organ dysfunction syndrome (MODS) within 24 h were risk factors of death in MDR Ab related sepsis group (P ＜ 0.05).Conclusions Patients with MDR Ab related sepsis have worse prognosis and spend more in related treatment.It is important to detect risk factors of death and implement targeting treatment early.