论文部分内容阅读
目的探讨动态临床肺部感染评分(CPIS)监测在急性呼吸窘迫综合征(ARDS)患儿病情及预后评估中的临床应用价值。方法收集2008年12月-2012年12月重症监护室(ICU)收治的ARDS患儿86例,经过积极治疗后86例ARDS患儿死亡46例,存活40例。统计分析两组CPIS的动态变化。结果生存组患儿第1,3,7天CPIS分别为6.12±1.38、7.83±1.57和5.34±1.13分,死亡组患儿第1,3,7天CPIS分别为6.94±1.42、8.70±1.56和9.55±1.62分。生存组患儿在第1,3,7天时CPIS均显著低于死亡组患儿(P<0.05),生存组CPIS第3天时CPIS达到高峰(P<0.05),以后逐渐减低(P<0.05),而在死亡组随着时间的推移CPIS则逐渐升高(P<0.05)。40例生存组ARDS患儿中有9例发展到多器官功能衰竭(MOF),发生率为22.5%,46例死亡组ARDS患儿中有43例发展到MOF,发生率为93.5%,统计学分析显示两组之间差异有统计学意义(P<0.01)。结论动态监测CPIS的变化可以反应出ARDS患儿的病情变化,可作为其预后评估的简易指标之一。
Objective To investigate the clinical value of dynamic clinical lung infection score (CPIS) monitoring in the prognosis and prognosis of children with acute respiratory distress syndrome (ARDS). Methods Totally 86 ARDS children admitted to intensive care unit (ICU) from December 2008 to December 2012 were enrolled. Among 86 ARDS patients, 46 died and 40 survived. Statistical analysis of the two groups CPIS dynamic changes. Results CPIS were 6.12 ± 1.38, 7.83 ± 1.57 and 5.34 ± 1.13 on the 1st, 3rd and 7th day in the survival group, respectively. The CPIS of the death group on the 1st, 3rd and 7th day were 6.94 ± 1.42, 8.70 ± 1.56 and 9.55 ± 1.62 points. CPIS in survival group was significantly lower than that in death group on the 1st, 3rd, 7th day (P <0.05), CPIS peaked on the 3rd day of CPIS in survival group (P <0.05), then decreased gradually (P <0.05) , While in the death group CPIS increased gradually with time (P <0.05). Nine of 40 survivors with ARDS progressed to multiple organ failure (MOF) at a rate of 22.5%. Forty-three of the 46 death patients with ARDS developed MOF at a rate of 93.5% Analysis showed that the difference between the two groups was statistically significant (P <0.01). Conclusion The dynamic changes of CPIS can reflect the changes of the disease in children with ARDS, which can be used as a simple index of prognosis evaluation.