本文選題：發(fā)熱 + 膿毒癥��； 參考：《中華醫(yī)院感染學(xué)雜志》2016年20期

【摘要】：目的研究以發(fā)熱為主訴的膿毒癥患者臨床資料及預(yù)后,尋找提示預(yù)后不良的早期預(yù)警指標。方法回顧性分析2014年1月-2016年1月以發(fā)熱為主訴的81例膿毒癥患者,根據(jù)預(yù)后分為預(yù)后良好組和預(yù)后不良組,其中預(yù)后良好組61例,預(yù)后不良組20例;比較兩組間臨床資料,并以預(yù)后為因變量,將組間差異指標進行l(wèi)ogistic回歸分析,以明確其與預(yù)后的關(guān)聯(lián)。結(jié)果全部81例膿毒癥患者中,預(yù)后不良組占24.69%,兩組間年齡、性別、體質(zhì)量指數(shù)等臨床情況差異均無統(tǒng)計學(xué)意義;預(yù)后不良組中肺部感染顯著高于預(yù)后良好組,預(yù)后不良組血紅蛋白顯著低于預(yù)后良好組,凝血酶時間顯著長于預(yù)后良好組,差異均有統(tǒng)計學(xué)意義(P0.05);血乳酸含量明顯高于預(yù)后良好組;logistic回歸分析提示血紅蛋白水平與不良預(yù)后負相關(guān),血乳酸水平和凝血酶時間與不良預(yù)后正相關(guān)。結(jié)論以發(fā)熱為主訴的膿毒癥患者,就診早期的血紅蛋白、血乳酸和凝血酶時間可能對預(yù)后有一定預(yù)警作用,其中較低的血紅蛋白水平,較高的血乳酸水平和較長的凝血酶時間均提示患者可能出現(xiàn)不良的預(yù)后情況。
[Abstract]:Objective to study the clinical data and prognosis of sepsis patients with fever, and to find early warning indicators for poor prognosis. Methods from January 2014 to January 2016, 81 patients with sepsis were divided into good prognosis group (61 cases) and poor prognosis group (20 cases) according to their prognosis. With the prognosis as dependent variable, the logistic regression analysis was carried out to determine the correlation between the different indexes and the prognosis. Results among the 81 patients with sepsis, the poor prognosis group was 24.69. There was no significant difference in age, sex, body mass index between the two groups, and the pulmonary infection in the poor prognosis group was significantly higher than that in the good prognosis group. Hemoglobin in poor prognosis group was significantly lower than that in good prognosis group, and thrombin time was significantly longer than that in good prognosis group. The results of logistic regression analysis showed that hemoglobin level was negatively correlated with poor prognosis, and blood lactate level and thrombin time were positively correlated with poor prognosis. Conclusion the hemoglobin, blood lactic acid and thrombin time in patients with sepsis with fever as the main complaint may have a certain early warning effect on prognosis, among which the lower hemoglobin level. Higher lactic acid levels and longer thrombin time all suggest poor prognosis.
【作者單位】： 解放軍總醫(yī)院急診科;
【基金】：國家科技重大專項(2013ZX1004805-003) 解放軍總醫(yī)院臨床科研扶持基金(2012FC-TSYS3033)
【分類號】：R459.7

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