脓毒症继发感染的危险因素分析.pdf

中文摘要

脓毒症继发感染的危险因素分析

摘要

目的:通过回顾性分析脓毒症患者临床资料，研究脓毒症患者住院

期间继发感染的独立危险因素以辅助临床诊疗。

方法:搜集2021年1月-2022年7月收治于河北医科大学第四医院重

症医学科脓毒症患者的临床资料，根据患者入ICU后48小时后是否出

现继发感染将患者分为单次感染组和继发感染组。搜集资料包括基本信

息、既往史、感染部位、入院治疗措施、入院基线指标、初次感染病原

体及感染部位、继发感染病原体及感染部位、预后指标等相关资料。采

用单因素分析和Logistic回归模型筛选脓毒症患者继发感染的相关危险

因素。

结果:共纳入70例脓毒症患者，分为单次感染组（40例）和继发感

染组（30例）。单因素分析提示两组患者在气管导管留置时间、中心静

脉导管留置时间、胃管留置时间、尿管留置时间、有创机械通气时间、

住院期间是否行纤维支气管镜吸痰其差异存在统计学意义(P0.05)。将影

响因素进行二分类多变量Logistic回归分析:纤维支气管镜吸痰是脓毒症

患者继发感染的独立保护因素，中心静脉导管留置时间是脓毒症患者继

发感染的独立危险因素。

结论:1.继发感染发生率42.86%。主要发生于入ICU第3天到第11

天内，占比达到70%。继发感染最常见的部位为呼吸道及肺部，其次是

血流感染。最常见的微生物是铜绿假单胞菌和鲍曼不动杆菌。2.继发感

染延长住院时间、住ICU时间、抗生素应用时间，增加住院费用。继

感染组的病死率为33.3%，是否继发感染不影响病死率。3.纤维支气管

镜吸痰则为脓毒症患者继发感染的独立保护因素，中心静脉导管留置时

间是脓毒症患者继发感染的独立危险因素。

关键词：脓毒症，继发感染，危险因素，Logistic回归分析

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目录

中文摘要············································································································1

英文摘要············································································································2

英文缩写············································································································4

前言············································································································5

材料与方法································································································5

结果············································································································7

讨论··········································································································12

结论··········································································································15

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