摘要
目的探讨多处创伤性骨折合并创伤性休克患者预后的影响因素。方法选取首都医科大学附属北京友谊医院2018年1月至2019年12月收治的多处创伤性骨折合并创伤性休克患者129例作为研究对象,依据住院治疗结局将其分为存活组(98例)和死亡组(31例)。收集患者的性别、年龄、创伤原因、发病时间、合并基础疾病、入院时急性生理与慢性健康状况评分系统Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、入院时创伤严重程度评分(injury severity score,ISS)、输血情况、入院24 h输液量、D-二聚体水平、C反应蛋白(C reactive protein,CRP)水平、休克持续时间、手术情况等信息,采用多因素Logistic回归分析影响多处创伤性骨折合并创伤性休克患者预后的独立危险因素。结果死亡组患者入院时APACHEⅡ评分、入院时ISS、D-二聚体水平、CRP水平均显著高于存活组(均P<0.05),休克持续时间>6 h患者占比显著高于存活组(P<0.05)。入院时APACHEⅡ评分、入院时ISS、D-二聚体水平、CRP水平和休克持续时间>6 h均为影响多处创伤性骨折合并创伤性休克患者预后的独立危险因素(均P<0.05)。结论入院时APACHEⅡ评分、入院时ISS、D-二聚体水平、CRP水平和休克持续时间为影响多处创伤性骨折合并创伤性休克患者预后的独立危险因素,应采取针对性预防措施以改善患者预后。
Objective To explore the influencing factors of prognosis in patients with multiple traumatic fractures combined with traumatic shock.Method A total of 129 patients with multiple traumatic fractures combined with traumatic shock admitted to Beijing Friendship Hospital,Capital Medical University from January 2018 to December 2019 were selected as study subjects,and they were divided into survival group(98 cases)and death group(31 cases)according to the outcome of hospitalization.Data of patients were collected,including sex,age,cause of injury,time of onset,combined basic diseases,acute physiology and chronic healthⅡ(APACHEⅡ)score,injury severity score(ISS),blood transfusion,24 h infusion volume,D-dimer level,C reactive protein(CRP)level,duration of shock,and operation.Multivariate Logistic regression was used to analyze the independent risk factors influencing the prognosis of patients with multiple traumatic fractures complicated with traumatic shock.Result APACHEⅡscore,ISS,D-dimer level,CRP level in death group were significantly higher than those in survival group(all P<0.05);the proportion of shock duration>6 h in death group was significantly higher than that in survival group(P<0.05).APACHEⅡscore,ISS,D-dimer level,CRP level and shock duration>6 h were independent risk factors of prognosis with multiple traumatic fractures combined with traumatic shock(all P<0.05).Conclusion APACHEⅡscore,ISS,D-dimer level,CRP level,and shock duration are independent risk factors that affecting the prognosis of patients with multiple traumatic fractures combined with traumatic shock targeted preventive measures should be taken to improve patient prognosis.
作者
王红银
王海云
徐彩云
Wang Hongyin;Wang Haiyun;Xu Caiyun(Emergency Department,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;General Practice,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《中国医学前沿杂志（电子版）》
2020年第11期72-75,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
创伤性骨折
创伤性休克
预后
影响因素
Traumatic fracture
Traumatic shock
Prognosis
Influencing factor
