摘要
为探讨全身炎症反应综合征的诊断与分期在儿科急重症的应用价值,对收入小儿重症监护病房175例以肺炎为主要感染以及非感染性疾病的危重患儿,按全身炎症反应综合征(SIRS)4项诊断标准与SIRS临床分期进行诊断。结果SIRS发生率为65.7％(115/175例),其中符合2项(Ⅰ期-早期)72例,符合3项(Ⅱ、Ⅲ期-中期)26例,符合4项(Ⅳ、Ⅴ期-晚期)17例。在SIRS中,早期发生率占62.6％(72/115例),病死率1.4％;中期占22.6％(26/115例),病死率7.7％;晚期占14.8％(17/115例),病死率41.2％,总病死率为8.7％。提示符合SIRS诊断标准越多,病情越重,病死率越高。同时还显示SIRS诊断结合临床分期不但可以解决既往认为SIRS 4项诊断标准过于宽松、涵盖范围广、敏感性高而特异性差的弊端,还可根据分期估计预后,并针对各期脏器受累严重程度有目的采取相应的治疗措施。
To explore the effect of the 4 items of the clinical criteria for diagnosis and the staging system for the systemic inflammatory response syndrome(SIRS) on the pediatric emergency medicine, 175 children with the critical conditions admitted in PICU were enrolled including those with pneumonia as the main infective diseases and non-infective disease and classified according to the 4 items of criteria for diagnosis and the staging system for SIRS. The results indicated that the incidence of SIRS was 65. 7% (115/175).Of them, 72 children(62. 6% ) with 2 items of the diagnostic criteria were identified as stage I (early stage), 26 children(22. 6% ) with 3 items of these criteria were considered as the stages II and III (intermediate stage), 17(14.8) had 4 items were classified as the stages IV and V (advanced stage) .The mortality in total was 8.7%, but the mortality for the stages IV and V was 41.2%. From this study indicating the more items of the diagnostic criteria, the patients had the more severe and much higher the mortality. It also suggested that diagnosis of SIRS combined with clinical staging could not only overcome the shortcomings of the SIRS criteria because of too much generalized system to establish the definite specialty, but the prognosis of such children could also be evaluated according to this staging system and appropriate measures could be taken according to the severity of the organ involvement in the different stages.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2002年第11期651-653,共3页
Journal of Clinical Pediatrics
