摘要
目的研究床旁超声胃窦运动指数(MI)与脓毒症胃肠功能障碍患者预后的相关性。方法选取2021年7月—2022年3月梅州市人民医院脓毒症胃肠功能障碍患者97例,按照28 d内生存情况分为预后良好组、预后不良组,比较不同预后基础资料及MI值,采用Logistic回归分析预后不良的影响因素;采用ROC及AUC评估MI对预后的评估价值。结果97例脓毒症胃肠功能障碍患者28 d内生存73例,死亡24例,死亡率为24.74%;不同预后患者性别、年龄、主要基础疾病、感染部位、恢复排便时间、肠鸣音恢复时间、机械通气时间比较,差异无统计学意义(P>0.05);预后不良组SOFA评分、APACHEⅡ评分、胃肠功能障碍评分、入住ICU时间大于预后良好组,CRRT治疗占比、MI值小于预后良好组(P<0.05);经Logistic回归分析,SOFA评分、APACHEⅡ评分、胃肠功能障碍评分、入住ICU时间均为脓毒症胃肠功能障碍患者预后不良的危险因素,CRRT治疗、MI值为预后不良的保护因素(P<0.05);经ROC分析显示,MI值预测脓毒症胃肠功能障碍患者预后的Cut-off值为0.848,AUC值为0.751,95%CI为0.652~0.833,灵敏度为87.50%,特异度为60.27%。结论床旁超声MI值与脓毒症胃肠功能障碍患者的预后具有明显相关性,且对预后具有一定预测价值。
Objective To study the correlation between bedside ultrasonic antral motility index(MI)and prognosis of patients with sepsisandgastrointestinal dysfunction.Methods Between July 2021 and March 2022,ninety-seven patients with septic gastrointestinal dysfunction underwent bedside ultrasonography to test the antral motility index in addition to conventional treatment,and were divided into good prognosis group and poor prognosis group according to the survival situation within 28 days after onsethospitalization.Relevant clinical data were collected.Logistic regression analysis was used to identify the influencing factors of poor prognosis,ROC analysis was used to assess the prognostic value of MI.Results 73 of the 97 cases survived within 28 days after onsethospitalization,and 24 died with the mortality of 24.74%.There were no significant differences in gender,age,main basic diseases,infection site,recovery defecation time,bowel sound recovery time,and mechanical ventilation time between the patients with different prognosis(all P>0.05).Compared with the good prognosis group,the SOFA score,ApacheⅡscore,and gastrointestinal dysfunction score of the poor prognosis group were all significantly higher,the ICU stay time was significantly longer,and the proportion of CRRT treatment and Mi value were significantly lower(all P<0.05).Logistic regression analysis showed that SOFA score,ApacheⅡscore,gastrointestinal dysfunction score,and ICU admission time were the risk factors of poor prognosis,CRRT treatment and Mi value were the protective factors of poor prognosis(all P<0.05).ROC analysis showed that the cut off value of MI value in predicting the prognosis of patients with sepsis gastrointestinal dysfunction was 0.848,AUC value was 0.751,95%CI was 0.652~0.833,the sensitivity was 87.50%,and the specificity was 60.27%.Conclusion Bedside ultrasound Mi value is significantly correlated with the prognosis of the patients with sepsis and gastrointestinal dysfunction,and has a certain predictive value for the prognosis.
作者
黄晓星
张华根
曾伟坚
彭贵霞
罗伟杰
陈明乾
HUANG Xiaoxing;ZHANG Huagen;ZENG Weijian;PENG Guixia;LUO Weijie;CHEN Mingqian(Department of Critical Care Medicine,Meizhou People's Hospital,Meizhou Guangdong 514000,China)
出处
《中国急救复苏与灾害医学杂志》
2023年第3期344-347,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
广东省中医药局科研项目(编号:20211392)。
关键词
脓毒症
胃肠功能障碍
床旁超声胃窦运动指数
预后
相关性
Sepsis
Gastrointestinal dysfunction
Bedside ultrasound antral motility index
Prognosis
Relevance
