本文選題：嚴(yán)重膿毒癥　切入點(diǎn)：臨床特征　出處：《廣東醫(yī)學(xué)》2017年22期

【摘要】：目的分析嚴(yán)重膿毒癥患者臨床特征及死亡預(yù)測(cè)因素。方法選擇135例膿毒癥患者為研究對(duì)象,對(duì)比生存患者與死亡患者的臨床特征和實(shí)驗(yàn)室檢測(cè)結(jié)果,并采用logistic回歸分析了解可預(yù)測(cè)患者死亡結(jié)局的因素。比較兩組患者基礎(chǔ)疾病情況、查爾森評(píng)分、實(shí)驗(yàn)室檢查結(jié)果以及臨床特征。結(jié)果 135例患者中病死29例,死亡率為21.48%;存活組67.90%的患者未合并基礎(chǔ)疾病,明顯高于死亡組的44.83%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。存活組基礎(chǔ)疾病數(shù)量主要合并1~2種,而死亡組大多合并3種或4種基礎(chǔ)疾病;存活組查爾森評(píng)分明顯低于死亡組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。入院后,存活組血乳酸濃度與心率均明顯低于死亡組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。存活組入院后體溫、白細(xì)胞計(jì)數(shù)、降鈣素原等指標(biāo)與死亡組相比,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。Logistic回歸顯示基礎(chǔ)疾病數(shù)量、查爾森評(píng)分、心率、血乳酸等是嚴(yán)重膿毒癥患者死亡的獨(dú)立預(yù)測(cè)因素。結(jié)論基礎(chǔ)疾病數(shù)量、查爾森評(píng)分、血乳酸濃度、心率等可作為嚴(yán)重膿毒癥患者有效的死亡預(yù)測(cè)因素,可用于臨床綜合判斷預(yù)后,并于臨床對(duì)患者危險(xiǎn)進(jìn)行有效分層,實(shí)現(xiàn)針對(duì)性治療,降低病死率。
[Abstract]:Objective to analyze the clinical characteristics and death prediction factors of patients with severe sepsis. Methods 135 patients with sepsis were selected to compare the clinical characteristics and laboratory results of survival and death. Logistic regression analysis was used to find out the factors that could predict the death outcome of the patients, and to compare the basic disease, the Charlson score, the results of laboratory examination and clinical features between the two groups. Results 29 of the 135 patients died. The mortality rate was 21.48%, 67.90% of the patients in the survival group did not have basic diseases, which was significantly higher than that in the death group (44.83%), the difference was statistically significant (P 0.05). The number of basic diseases in the survival group was mainly associated with 12 kinds of basic diseases, while most of the patients in the death group were combined with 3 or 4 kinds of basic diseases. After admission, the blood lactate concentration and heart rate in the survival group were significantly lower than those in the death group, and the difference was statistically significant (P 0.05). The body temperature and white blood cell count in the survival group were significantly lower than those in the dead group. Compared with the death group, there was no significant difference between the procalcitonin and other indexes. Logistic regression showed that the number of basic diseases, Charson's score, heart rate and blood lactic acid were independent predictors of death in patients with severe sepsis. Charlson score, blood lactic acid concentration and heart rate can be used as effective predictors of death in patients with severe sepsis, and can be used to judge the prognosis comprehensively, and to effectively stratify the risk of patients in clinic, to achieve targeted treatment, and to reduce the mortality.
【作者單位】： 遵義市第一人民醫(yī)院重癥醫(yī)學(xué)科;
【基金】：貴州省科學(xué)技術(shù)基金項(xiàng)目(編號(hào):黔科合J字[2014]2173號(hào)) 遵義市科技計(jì)劃課題(編號(hào):遵市科合社字[2015]05號(hào))
【分類(lèi)號(hào)】：R459.7

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