孟加拉石树医院及研究所重症监护病房收治登革热患者的预后分析

R. Akhter, Shubhra Paul, Fannana Ahmed
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引用次数: 0

摘要

背景:最近孟加拉国儿童中再次出现登革热患者,给我国儿童的发病率和死亡率造成了巨大负担。目的:本研究旨在记录孟加拉国石树医院和研究所(BSH&I) ICU收治的登革热患者的预后。方法:对2019年6月1日至2019年12月31日在BSH&I PICU住院的登革热感染儿童进行回顾性观察研究。所有通过血清学检测(NS1、登革热IgG和IgM)诊断为登革热的患者以及PICU收治的患者均纳入本研究。共纳入126例患者。数据来自登革热患者的医院记录。结果:登革热患者平均年龄5.91(±3.53)岁。登革热患者以城市居民居多;其中女性占52.4%。入院时的主要症状为发热119例(94.4%),低血压106例(84.1%)。诊断为重症登革热(SD)的病例最多(62.7%),其次是有警告体征的登革热(DFWS)(20.6%)和扩展型登革热综合征(EDS)(16.7%)。晶体移植最多(98.4%),胶体移植约51.6%。大量患者接受输血(23%),接受血浆(23%),接受白蛋白(33.3%)。以吸氧为主(80.2%);87.3%的病例使用抗生素。55%的患者接受了肌力疗法来治疗休克。总体结果显示,75.4%的患者治愈出院。只有21.43%的患者在PICU中死亡,尽管有基于协议的管理。79人中重症登革热死亡15人(18.9%),其次是有警示迹象的登革出血热死亡8人(30.7%),扩展型登革综合征死亡21人(19.04%)。结论:本回顾性研究发现大多数入住PICU的登革热患者存活。然而,有警告迹象的登革热的死亡率高于严重登革热病例的死亡率。警告信号的延迟识别以及延迟转诊到PICU可能是造成这种结果的原因。DS(儿童)H J 2021;37 (2): 103 - 108
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcome of Dengue Patients Admitted in the PICU of Bangladesh Shishu Hospital & Institute
Background: Recent re-emergence of dengue patient among Bangladeshi children have created a huge burden in the morbidity and mortality of our children. Objectives: This study was designed to document the outcome of dengue patients, admitted in the ICU of Bangladesh Shishu Hospital & Institute (BSH&I). Methods: This retrospective observational study was performed among the children having dengue infection and who were admitted in the PICU of BSH&I from 1st June 2019 to 31st December 2019. All patients who were diagnosed as dengue fever by serological tests (NS1, Dengue IgG & IgM) and those who were admitted in the PICU were included in this study. Total one hundred and twenty-six patients were enrolled. Data were collected from hospital record of the Dengue patients. Results: Mean age of the Dengue patients were 5.91(±3.53) years. Most of the patients suffering from dengue fever were urban dwellers; among them 52.4% were female. Presenting symptoms during admission in the PICU were fever which was present in 119 patients (94.4%), followed by hypotension in 106 (84.1%) patients. Severe dengue (SD) was diagnosed in maximum number of cases (i.e., 62.7%), followed by Dengue fever with warning signs (DFWS) in (20.6%) and Expanded Dengue Syndrome (EDS) in 16.7%. Maximum cases received crystalloid (98.4%), about 51.6% patients received colloid. A good number of patients received blood transfusion (23%), plasma was received in (23%) and albumin was received in (33.3%) cases. Majority of the patients received Oxygen (80.2%); antibiotics were prescribed in 87.3% cases. Fifty-five percent patients received inotropes for the management of shock. The overall outcome revealed 75.4% patients were cured and discharged. Only 21.43% patients died in the PICU despite protocol-based management. Death due to severe dengue was 15(18.9%) out of 79, followed by death due to Dengue Hemorrhagic fever with warning signs which was 8 (30.7%) out of 26 and death in Expanded Dengue syndrome was 4(19.04%) out of 21. Conclusion: This retrospective study found that majority of the Dengue patients admitted in PICU has survived. However the death due to Dengue with warning signs was higher than death in severe Dengue cases. Delayed recognition of warning signs along with delayed referral to PICU may be responsible for such outcome. DS (Child) H J 2021; 37(2): 103-108
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