CAJ | 학술논문

[目的]探讨全身炎症反应综合征（SIRS）的诊断与其分期分级在儿科急重症中的应用价值。[方法]对收入小儿重症监护病房的136例感染及非感染性疾病的危重患儿，按SIRS 4项诊断标准与SIRS临床分期、定义分级进行分组。[结果]136例患者中，符合2项（Ⅰ期-早期；脓毒症）36例（占26．5％），符合3项（Ⅱ、Ⅲ期-中期；严重脓毒症）70例（占51．5％），符合4项（Ⅳ、Ⅴ期-中期；脓毒性休克）30例（占22．0％）。总病死率为11．7％，随着SIRS病情的逐渐加重，多器官功能障碍综合征（MODS）病例逐渐增多，病死率不断增高。两组MODS发生率分别为7．1％和83％（ P＜0．01），病死率分别为7．1％和36．6％（ P ＜0．01）。[结论]SIRS诊断标准和临床分级相结合对SIRS患儿进行评估，可以判断病情严重程度和估计预后。
[목적]탐토전신염증반응종합정（SIRS）적진단여기분기분급재인과급중증중적응용개치。[방법]대수입소인중증감호병방적136례감염급비감염성질병적위중환인，안SIRS 4항진단표준여SIRS림상분기、정의분급진행분조。[결과]136례환자중，부합2항（Ⅰ기-조기；농독증）36례（점26．5％），부합3항（Ⅱ、Ⅲ기-중기；엄중농독증）70례（점51．5％），부합4항（Ⅳ、Ⅴ기-중기；농독성휴극）30례（점22．0％）。총병사솔위11．7％，수착SIRS병정적축점가중，다기관공능장애종합정（MODS）병례축점증다，병사솔불단증고。량조MODS발생솔분별위7．1％화83％（ P＜0．01），병사솔분별위7．1％화36．6％（ P ＜0．01）。[결론]SIRS진단표준화림상분급상결합대SIRS환인진행평고，가이판단병정엄중정도화고계예후。
[Objective] To explore the value of diagnosis grading and staging of systemic inflammatory re-sponse syndrome(SIRS) in children with acute and critical disease .[Methods]Totally 136 critical children with infectious or non-infectious disease in pediatric ICU were grouped by 4 items of diagnostic criteria of SIRS and clinical grading and staging .[Results] In 136 patients ,36 cases(26 .5% ) accorded with 2 items of criteria (stage Ⅰ-early stage ,sepsis) ,70 patients (51 .5% ) accorded with 3 items of criteria (stage Ⅱ ,Ⅲ-middle stage ,severe sepsis) and 30 patients(22 .0% ) accorded with 4 items of criteria(stage Ⅳ ,Ⅴ-middle stage , septic shock) .The total mortality rate was 11 .7% .The number of multiple organ dysfunction score(MODS) and the mortality rate increased with deterioration of SIRS .The incidence rates of MODS in two groups were 7 .1% and 83% respectively( P <0 .01) ,and the mortality rates were 7 .1% and 36 .6% respectively( P <0 .01) .[Conclusion] The diagnostic criteria combined with clinical grading of SIRS for evaluating SIRS in chil-dren can judge the severity degree of disease and assess the prognosis .