摘要
目的探讨重症监护病房(ICU)休克患者死亡风险的危险因素。方法采用回顾性分析方法,收集2012年1月至2013年10月我院收治的162例休克患者的临床资料,分为28 d存活组(n=72)和死亡组(n=90)。详细记录其一般情况,包括性别、患者类别、转入地、血管活性药物、年龄、入ICU时的病程、氧合指数(PaO2/FiO2)、格拉斯哥评分、ICU住院时间及相关实验室指标[总胆红素(Total bilirubin,TBIL)、肌酐(Creatinine,Cr)、血小板(Platelet,Plt)]。经单因素、多因素分析患者死亡的危险因素。结果经多因素Logistic回归分析显示,年龄≥65岁、GCS评分<11分和Cr≥130μmol/L是休克患者28 d死亡的危险因素(OR>1,P<0.05),而使用血管活性药物和ICU住院时间≥8 d则是保护因素(OR<1,P<0.05)。结论高龄、昏迷和肾功能损害是休克患者28 d死亡的危险因素,临床上应早期识别并积极采取有效措施进行干预。
Objective To explore the risk factors of death in shock patients in intensive care unit(ICU).Methods The clinical data of 162 shock patients admitted to our hospital from January 2012 to October 2013 were collected using the retrospective analysis method.They were divided into the 28-day survival group(72 cases)and the death group(90 cases).Their general information was recorded in detail,including gender,patient type,transfer place,vasoactive drugs,age,course of illness when entering the ICU,oxygenation index(PaO2/FiO2),Glasgow score,ICU length of stay,and related laboratory indicators[total Bilirubin(TBIL),Creatinine(Cr),Platelet(Plt)].The risk factors of death were analyzed by univariate and multivariate analysis.Results Multivariate Logistic regression analysis showed that age≥65 years,GCS score<11 points,and Cr≥130μmol/L were risk factors for 28-day death in shock patients(OR>1,P<0.05),while the use of vasoactive drugs and ICU hospital stay≥eight days were the protective factors(OR<1,P<0.05).Conclusion Old age,coma,and renal impairment are risk factors for 28-day death in shock patients.Early clinical identification and effective measures should be taken to intervene.
作者
邓鸿胜
怀佳萍
陈科强
DENG Hongsheng;HUAI Jiaping;CHEN Keqiang(Department of Critical Care Medicine,Jinhua Central Hospital in Zhejiang Province,Jinhua 321000,China;Department of Laboratory Medicine,Jinhua Central Hospital in Zhejiang Province,Jinhua 321000,China)
出处
《中国现代医生》
2021年第16期60-63,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2020KY1014)
浙江省金华市科技局社会发展类重点项目(2018-3-012)。
