發(fā)布時(shí)間：2018-03-24 00:00

  本文選題：嚴(yán)重膿毒癥　切入點(diǎn)：膿毒性休克　出處：《山東大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2016年10期

【摘要】：目的探討嚴(yán)重膿毒癥與膿毒性休克死亡危險(xiǎn)因素,分層分析影響不同生存期患者預(yù)后的因素。方法回顧性分析2013年1月至2014年12月108例嚴(yán)重膿毒癥與膿毒性休克患者臨床資料,通過多因素Cox回歸模型明確死亡的獨(dú)立危險(xiǎn)因素。結(jié)果總死亡率為53.7%,生存期30 d,30 d~89 d,90 d~365 d患者死亡率分別為27.8%、24.4%與15.3%。急性生理與慢性健康評分(APACHE-Ⅱ評分)、查爾森合并癥指數(shù)(CCI)與降鈣素原變化率(△PCT)是影響死亡率的獨(dú)立預(yù)后因素,HR(95%CI)分別為1.105(1.066~1.146)、1.390(1.210~1.596)與0.996(0.995~0.997)。分層分析,生存期30 d者,預(yù)后因素為APACHE-Ⅱ評分(HR=1.104,95%CI:1.052~1.158)、CCI(HR=1.462,95%CI:1.204~1.775)、△PCT(HR=0.992,95%CI:0.989~0.995)與ICU住院時(shí)間(HR=0.893,95%CI:0.841~0.949);生存期30 d~89 d者,預(yù)后因素為APACHE-Ⅱ評分(HR=1.102,95%CI:1.026~1.183)與△PCT(HR=0.996,95%CI:0.994~0.998)。生存期90 d~365 d者,僅CCI(HR=1.689,95%CI:1.065~2.679)影響預(yù)后。結(jié)論 APACHE-Ⅱ評分、CCI與△PCT為影響嚴(yán)重膿毒癥與膿毒性休克患者死亡率的獨(dú)立預(yù)后因素。但對于不同生存期的死亡患者,其預(yù)后因素稍有不同,需進(jìn)一步開展多中心大樣本的前瞻性隊(duì)列研究證實(shí)。
[Abstract]:Objective to investigate the risk factors of death in patients with severe sepsis and septic shock, and to analyze the prognostic factors of patients with different survival periods. Methods the clinical data of 108 patients with severe sepsis and septic shock from January 2013 to December 2014 were retrospectively analyzed. The independent risk factors of death were determined by multivariate Cox regression model. Results the total mortality rate was 53.7. The mortality rate of patients with 30 days of survival was 27.8% and 15.3%, respectively. The acute physiological and chronic health score was appACHE- 鈪，

本文編號：1655767