重症监护室烧伤感染患者脓毒症的病原菌分布及影响因素研究

目的:探讨重症监护室(ICU)烧伤感染患者脓毒症的发生情况及病原菌分布,并分析其危险因素,为防治ICU烧伤感染患者脓毒症提供理论依据。方法:收集我院2016年7月-2019年7月期间的86例ICU烧伤感染患者的临床资料,依据是否发生脓毒症,将其分为脓毒症组和非脓毒症组,比较两组的基本资料等情况,分析ICU烧伤感染患者脓毒症的发生率及病原菌分布,并分析ICU烧伤感染患者脓毒症发生的影响因素。结果:86例ICU烧伤感染患者中有33例发生脓毒症,发生率为38.37%;ICU烧伤感染患者脓毒症病原菌主要是革兰阴性杆菌(占54.55%),其次是革兰阳性球菌(占42.42%);单因素结果分析发现,烧伤至入院时间、合并糖尿病、吸入性损伤、首次手术时间以及烧伤面积与ICU烧伤感染患者脓毒症的发生有关(P<0.05);多因素Logistic回归分析发现,首次手术时间>2d、TBSA>50%是ICU烧伤感染患者脓毒症发生的独立危险因素(P<0.05)。结论:ICU烧伤感染患者易发生脓毒症,首次手术时间>2d以及TBSA>50%是其发生的独立危险因素,临床应采取针对性预防措施,以降低ICU烧伤感染患者脓毒症发生率。

Study on Pathogenic Bacteria Distribution and Influencing Factors of Sepsis in Patients with Burn Infection in Intensive Care Unit

ABSTRACT Objective: To explore the incidence and the distribution of pathogenic bacteria of sepsis in patients with burn infection in intensive care unit(ICU), and analyze the risk factors, so as to provide theoretical basis for the prevention and treatment of sepsis in patients with burn infection in ICU. Methods: The clinical data of 86 patients with burn infection in ICU from July 2016 to July 2019 were collected. According to whether sepsis occurred, they were divided into sepsis group and non sepsis group. The incidence and distribution of pathogenic bacteria of sepsis in patients with burn infection in ICU were analyzed, and the influencing factors of sepsis in patients with burn infection in ICU were analyzed. Results: Among the 86 patients with burn infection in ICU, 33 had sepsis, the incidence was 38.37%; the main pathogens of sepsis in patients with burn infection in ICU were gram negative bacilli (54.55%), followed by gram positive cocci (42.42%); single factor analysis showed that the time from burn to admission, diabetes mellitus, inhalation injury, first operation time, and burn area were related to sepsis in patients with burn infection in ICU(P<0.05). Multiple Logistic regression analysis showed that the first operation time>2d, TBSA>50% were independent risk factors of sepsis in patients with burn infection in ICU(P < 0.05). Conclusion: Patients with burn infection in ICU are prone to sepsis, the first operation time>2d, TBSA>50%are the independent risk factors for sepsis.In order to reduce the incidence of sepsis in patients with burn infection in ICU, we should take preventive measures.