| Background and ObjectiveSeptic shock has been the focus of intensive medical research for many years,with its critical condition,high fatality rate and heavy economic burden.After manyyears of exploration and research,the more in-depth and comprehensive understanding of septic shock.In 2016,based on decades of research and clinical observation,there is a new definition of sepsisand septic shock,anti-infection treatment and corresponding organ function support technology also made significant progress,however,in clinical practiceobservation,morbidity and mortality of septic shock does not seem to have obvious decline.Theresearchon septic shock epidemiological data is less,and thedata isincomplete.Thisstudyis to understand the incidence,etiology,pathogenesis,treatment and prognosis ofseptic shock inthefirst affiliated hospital of zhengzhou university,andtoanalyze the factors ofaffecting the patients prognosis of patients with septic shock.MethodsCollected the patients who diagnosis septic shock or sepsis shock in the hospital from 2010.10.01 to 2017.06.30 in the first affiliated hospital of zhengzhou university.Artificial refer to the above patients medical records,and according to the hospital information,eliminate aged less than 15 patients and no more than 24 hours in hospital.The rest as the condition for patients,to collect these patients information in hospital and analyze.Results703 patients were selected.Comparison of death and survival patients,the total time of hospitalization(M 6:10.5,P< 0.001),no basic diseases(81:83,P = 0.012),blood system of malignant tumor(51:15,P = 0.001),chronic liver function failure(43:14,P = 0.007),statistical differences between the two.The number of patients admitted to ICU was 556,and the incidence of ICU was 5.7%.Compared to death patients with survival patients,ICU time of hospitalization(M 3:5,P = 0.004),APACHE ? score(M 23:16,P< 0.001),mechanical ventilation time(M 5:0,P< 0.001),total organ failure(M 4:3,P< 0.001),require CRRT treatment(81:25,P< 0.001),complicated with ARDS(27:5,P< 0.001),statistical differences between the two.The most common infection sites were pulmonary infection,accounting for 78.4%(n=551).Secondly was abdominal infection,accounting for 39.3%(n=276).365 patients infected with multiple sites(the infection site was more than 2).The most common pathogenic bacteria for e.coli,up to 29.7% of patients(n = 30),followed by acinetobacterbaumannii,klebsiella pneumoniae,staphylococcus aureus,pseudomonas aeruginosa,accounted for 22.8%(n = 23),19.8%(n = 20),17.8%(n = 18),9.9%(n = 20).The total number of death patients was 372,52.9 percent of the mortality rate.The mortality rate of ICU was 24.5%(n=136),and the 28 days mortality after discharge was 57.9%(n=322).ICU time of hospitalization,APACHE ? score,mechanical ventilation time,number of organ failure as the risk factors for prognosis in hospitalized patients.ConclusionPatients with septic shock have higher mortality than other diseases,high morbidity of ICU,high cost and poor prognosis.For patients with SIRS,the prevalence of SOFA score is low.So when the patients turn to ICU,they are in a serious condition.PACHE ? score,mechanical ventilation time,number of organ failure and ICU time of hospitalization was the independent risk factors influencing the prognosis of septic shock.It is suggested to popularize SOFA score and improve the degree of standardization. |
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