急性胃肠穿孔继发脓毒症的临床特征和预后影响因素评价(1)
[摘要] 目的 探讨急性胃肠穿孔继发脓毒症的临床特征，评估影响其预后效果的因素。方法 方便选取2015年1月—2018年2月期间在该院接受治疗的50例胃肠穿孔患者，依照是否产生脓毒症分为胃肠穿孔伴脓毒症组(观察组)和胃肠穿孔不伴脓毒症组(空白组)。比较两组患者一般资料与各项指标检查结果。结果 入组50例病例中，继发脓毒症20例(40.0%)；观察组患者年龄(67.5±10.2)岁、血糖(6.8±2.4)mmol/L、乳酸(3.0±1.4)mmol/L、SOFA评分(5.7±3.3)分，总住院时间(36.74±5.4)d，与对照组对应值(55.4±10.7)岁、(5.8±1.3)mmol/L、(1.4±0.8)mmol/L、(0.6±0.5)分、(13.54±2.4)d相比，差异有统计学意义(t=4.210， 4.347， 8.457， 12.014，11.254，P<0.05)。回归分析结果表明， MAP与GCS 评分是胃肠穿孔合并脓毒症者死亡的独立危险因素。结论 胃肠穿孔患者脓毒症发病率较高，且风险因素相对较多，只有采取降低 MAP与GCS 评分的相关措施，才有可能优化患者生存质量。
[关键词] 急性胃肠穿孔；脓毒症；临床特征；预后；影响因素
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2018)07(a)-0082-03
Clinical Characteristics and Prognostic Factors of Sepsis Secondary to Acute Gastrointestinal Perforation
MAO Dong-lin， GENG Yong-yong
Department of Emergency Surgery， People's Hospital of Tumushuke City， Tumushuke， Xinjiang， 843900 China
[Abstract] Objective This paper tries to investigate the clinical characteristics of acute gastrointestinal perforation secondary sepsis， and to evaluate the prognostic factors. Methods 50 patients with gastrointestinal perforation who were treated in the hospital between January 2015 and February 2018 were convenient selected and classified into gastrointestinal perforation with sepsis group (observation group) and gastrointestinal perforation according to whether sepsis was produced or not. Sepsis group (blank group). Compare the general data of the two groups with the results of the various indicators. Results Among the 50 patients enrolled， 20 patients(40.0%) were secondary to sepsis； the patients in the observation group were (67.5±10.2)years old， blood glucose (6.8±2.4)mmol/L， lactic acid (3.0±1.4)mmol/L， and SOFA scores (5.7±3.3)points， total hospital stay (36.74±5.4)days， corresponding to the control group (55.4±10.7)years， (5.8±1.3)mmol/L， (1.4±0.8)mmol/L， (0.6±0.5)points， (13.54±2.4)d， the difference was statistically significant(t=4.210， 4.347， 8.457， 12.014，11.254，P<0.05). Regression analysis results showed that MAP and GCS scores were independent risk factors for gastrointestinal perforation with sepsis. Conclusion The incidence of sepsis in patients with gastrointestinal perforation is high， and the risk factors are relatively high. Only by taking relevant measures to reduce MAP and GCS scores can it be possible to optimize the quality of life of patients.
[Key words] Acute gastrointestinal perforation； Sepsis； Clinical features； Prognosis； Influencing factors
“膿毒”被称之为“疽毒症”，其是一类由感染诱发的周身炎性反应。当下，全身炎症反应综合征(SIRS)与多器官功能障碍综合征(MODS)已经被认为是脓毒症诊断的金标准[1]。但是由于脓毒症自身的复杂性与多变性，以致很多临床医师对其缺乏全面认识，漏诊与误诊极为常见[2]。该文采用回顾性分析方便选择2015年1月—2018年2月期间在该院接受治疗的50例胃肠穿孔患者，对胃肠穿孔继发脓毒症患者的临床症状与预后情况进行分析，希望对脓毒症诊断有指导意义，现报道如下。, 百拇医药(冒东林 耿永勇)
[关键词] 急性胃肠穿孔；脓毒症；临床特征；预后；影响因素
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2018)07(a)-0082-03
Clinical Characteristics and Prognostic Factors of Sepsis Secondary to Acute Gastrointestinal Perforation
MAO Dong-lin， GENG Yong-yong
Department of Emergency Surgery， People's Hospital of Tumushuke City， Tumushuke， Xinjiang， 843900 China
[Abstract] Objective This paper tries to investigate the clinical characteristics of acute gastrointestinal perforation secondary sepsis， and to evaluate the prognostic factors. Methods 50 patients with gastrointestinal perforation who were treated in the hospital between January 2015 and February 2018 were convenient selected and classified into gastrointestinal perforation with sepsis group (observation group) and gastrointestinal perforation according to whether sepsis was produced or not. Sepsis group (blank group). Compare the general data of the two groups with the results of the various indicators. Results Among the 50 patients enrolled， 20 patients(40.0%) were secondary to sepsis； the patients in the observation group were (67.5±10.2)years old， blood glucose (6.8±2.4)mmol/L， lactic acid (3.0±1.4)mmol/L， and SOFA scores (5.7±3.3)points， total hospital stay (36.74±5.4)days， corresponding to the control group (55.4±10.7)years， (5.8±1.3)mmol/L， (1.4±0.8)mmol/L， (0.6±0.5)points， (13.54±2.4)d， the difference was statistically significant(t=4.210， 4.347， 8.457， 12.014，11.254，P<0.05). Regression analysis results showed that MAP and GCS scores were independent risk factors for gastrointestinal perforation with sepsis. Conclusion The incidence of sepsis in patients with gastrointestinal perforation is high， and the risk factors are relatively high. Only by taking relevant measures to reduce MAP and GCS scores can it be possible to optimize the quality of life of patients.
[Key words] Acute gastrointestinal perforation； Sepsis； Clinical features； Prognosis； Influencing factors
“膿毒”被称之为“疽毒症”，其是一类由感染诱发的周身炎性反应。当下，全身炎症反应综合征(SIRS)与多器官功能障碍综合征(MODS)已经被认为是脓毒症诊断的金标准[1]。但是由于脓毒症自身的复杂性与多变性，以致很多临床医师对其缺乏全面认识，漏诊与误诊极为常见[2]。该文采用回顾性分析方便选择2015年1月—2018年2月期间在该院接受治疗的50例胃肠穿孔患者，对胃肠穿孔继发脓毒症患者的临床症状与预后情况进行分析，希望对脓毒症诊断有指导意义，现报道如下。, 百拇医药(冒东林 耿永勇)