摘要
目的探讨影响外科重症监护病房（sIcu）严重腹腔感染患者预后的危险因素。方法回顾性分析2008年1月至2011年4月本院SICU收治的69例严重腹腔感染患者的临床资料，按患者出SICU时的结局分为存活组（42例）和死亡组（27例），采用单因素分析和多因素logistic回归分析筛选和判定与SICU严重腹腔感染患者预后相关的危险因素。结果单因素分析结果显示，急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分、腹腔感染灶处理不充分、初始抗菌药物治疗不适当以及合并脓毒性休克是影响SICU严重腹腔感染患者预后的危险因素[存活组分别为（11．76±3．48）分、3例、3例和24例；死亡组分别为（17．12±4．50）分、21例、15例和27例，均P〈0．01]；logistic回归分析表明，APACHEⅡ评分〉15分和腹腔感染灶处理不充分是影响预后的独立危险因素，P值分别为0．044和0．018，相对危险度（RR值）分别为6．846和21．319。结论动态监测APACHEII评分、及时充分处理腹腔感染灶，可以降低SICU严重腹腔感染患者的病死率。
Objective To investigate the risk factors related to prognosis of patients with severe intra-abdominal infection （SIAI） in surgical intensive care unit （SICU）. Methods Clinical data of 69 patients with SIAI, who were hospitalized during January 2008 and April 2011 in SICU, were analyzed retrospectively. According to the outcome at discharge from SICU, 69 patients were divided into two groups： the survivors 42 cases; the deceased 27 cases. The potential risk factors of SIAI patients in SICU were, analyzed by univariate analysis and logistic regression analysis. Results Univariate analysis showed that average acute physiology and chronic health evaluation II （APACHE II ） scores （the survival group： 11.76 ± 3.48; the death group： 17.12 ± 4.50）, inadequate treatment of intra-abdominal infection （3 survivors, 21 deceased）, inadequate initial antibiotic treatment （3 survivors, 15 deceased） and septic shock （24 survivors, 27 deceased） were risk factors for mortality （all P〈0.01 ）. Logistic regression analysis showed that average APACHE I scores over 15 [relative risk （RR）： 6.846, Pvalue： 0.0441 and insufficient treatment of intra-abdominal infection （RR： 21.319, P value ： 0.018 ） were the independent risk factors in SIAI patients in SICU. Conclusion To decrease the mortality of SIAI patients in SICU, more attention should be paid to monitor APACHE I scores and to handle intra-abdominal infection adequately.
出处
《中国危重病急救医学》
CAS
CSCD
北大核心
2012年第3期162-165,共4页
Chinese Critical Care Medicine
关键词
严重腹腔感染
预后
危险因素
疾病严重程度评分
重症监护病房
Severe intra-abdominal infection
Prognosis
Risk factor
The severity of disease classification system
Intensive care unit
