关键词: 儿童, 脓毒症休克, 重症监护病房, 临床特点, 预后

Abstract: Objective　To investigate the clinical characteristics and influencing factors of prognosis of PICU children with septic shock. Methods　According to the 2015 version of China's Expert Consensus on the Diagnosis and Treatment of Septic Shock （Septic Shock） in Children，a  total of 104 children with septic shock who were admitted to the PICU Ward of Shengjing Hospital of China Medical University from January 2015 to December 2019 were screened out.  Study the onset status and clinical characteristics of septic shock in children， and at the same time through univariate analysis and Logistic regression analysis，learn about the independent risk factors related to the prognosis of septic shock. Results　There were 104 children diagnosed with septic shock in the 5 years，accounting for 2% of the PICU hospitalized children during the same period. Among them，60 were boys and 44 were girls. The median age was 8 months，and infants and young children accounted for 77.9%（81 /104）; the overall mortality rate was 55.8%（58/104）; the digestive tract was the most common site of infection（48.1%），followed by the respiratory system（ 23.1%）; the proportion of confirmed pathogenic bacteria was 45.2%（47/104）；children with confirmed bacterial infection were gram-negative bacilli and gram-positive cocci；the top three bacteria were Escherichia coli，Pseudomonas aeruginosa and Streptococcus pneumoniae. Among 47 specimens with confirmed pathogen infection，42 cases were tested for drug sensitivity，and the drug resistance rate was 92.9%（39/42）. nivariate analysis suggested that mechanical ventilation，vasoactive drug use，respiratory and cardiac arrest，coagulation function，blood glucose，lactate，albumin，VIS score，PRISM score，PCIS score，and oxygenation index（P/F）≤300 were related to the death of children with septic shock;multivariate stepwise logistic regression showed that mechanical ventilation，respiratory and cardiac arrest and oxygenation index ≤300 were independent risk factors for death in septic shock，and albumin >30 g/L was a protective factor. Conclusion　The fatality rate of septic shock in PICU children is extremely high. The primary disease should be treated actively，and mechanical ventilation and vasoactive drugs should be used rationally to improve lung function and maintain hemodynamic stability. Enhancing management of mechanical ventilation and correcting hypoalbuminemia may be effective ways to reduce the mortality rate.

Key words: child, septic shock, intensive care unit, clinical features, prognosis