广西医学
廣西醫學
엄서의학
GUANGXI MEDICAL JOURNAL
2014年
9期
1246-1248
,共3页
李政钊%曾光%叶雨%梁昆
李政釗%曾光%葉雨%樑昆
리정쇠%증광%협우%량곤
多器官功能障碍综合征%多发伤%危险因素%急诊
多器官功能障礙綜閤徵%多髮傷%危險因素%急診
다기관공능장애종합정%다발상%위험인소%급진
Multiple organ dysfunction syndrome%Multiple trauma%Risk factor%Emergency
目的：探讨多发伤患者并发多器官功能障碍综合征（ MODS）的危险因素，为临床诊治提供参考。方法回顾性分析154例多发伤患者临床资料，根据患者有无并发MODS分为MODS组（84例）与非MODS组（70例），分析相关因素。结果 MODS组患者在入院后6 h之内休克纠正率、格拉斯哥评分（GCS）、红细胞计数、血小板计数明显低于非MODS组（ P＜0．05）；患者年龄、创新严重程度评分（ ISS ）、APACHEⅢ评分、白细胞计数、随机血糖高于非MODS组（ P＜0．05）；非条件多因素logistic回归分析结果显示患者入院后6 h之内休克未纠正、ISS分值高、APACHEⅢ评分高是患者并发MODS 的独立危险因素（ P ＜0．05）；MODS 组死亡率为55．95％，高于非MODS组的14．29％（ P＜0．05）；MODS发生率与死亡率呈正相关（ P＜0．05）。结论多发伤患者并发MODS的危险因素主要为入院后未及时纠正休克、ISS分值及APACHEⅢ评分高，对存在以上危险因素的患者入院后要注意MODS的发生。
目的：探討多髮傷患者併髮多器官功能障礙綜閤徵（ MODS）的危險因素，為臨床診治提供參攷。方法迴顧性分析154例多髮傷患者臨床資料，根據患者有無併髮MODS分為MODS組（84例）與非MODS組（70例），分析相關因素。結果 MODS組患者在入院後6 h之內休剋糾正率、格拉斯哥評分（GCS）、紅細胞計數、血小闆計數明顯低于非MODS組（ P＜0．05）；患者年齡、創新嚴重程度評分（ ISS ）、APACHEⅢ評分、白細胞計數、隨機血糖高于非MODS組（ P＜0．05）；非條件多因素logistic迴歸分析結果顯示患者入院後6 h之內休剋未糾正、ISS分值高、APACHEⅢ評分高是患者併髮MODS 的獨立危險因素（ P ＜0．05）；MODS 組死亡率為55．95％，高于非MODS組的14．29％（ P＜0．05）；MODS髮生率與死亡率呈正相關（ P＜0．05）。結論多髮傷患者併髮MODS的危險因素主要為入院後未及時糾正休剋、ISS分值及APACHEⅢ評分高，對存在以上危險因素的患者入院後要註意MODS的髮生。
목적：탐토다발상환자병발다기관공능장애종합정（ MODS）적위험인소，위림상진치제공삼고。방법회고성분석154례다발상환자림상자료，근거환자유무병발MODS분위MODS조（84례）여비MODS조（70례），분석상관인소。결과 MODS조환자재입원후6 h지내휴극규정솔、격랍사가평분（GCS）、홍세포계수、혈소판계수명현저우비MODS조（ P＜0．05）；환자년령、창신엄중정도평분（ ISS ）、APACHEⅢ평분、백세포계수、수궤혈당고우비MODS조（ P＜0．05）；비조건다인소logistic회귀분석결과현시환자입원후6 h지내휴극미규정、ISS분치고、APACHEⅢ평분고시환자병발MODS 적독립위험인소（ P ＜0．05）；MODS 조사망솔위55．95％，고우비MODS조적14．29％（ P＜0．05）；MODS발생솔여사망솔정정상관（ P＜0．05）。결론다발상환자병발MODS적위험인소주요위입원후미급시규정휴극、ISS분치급APACHEⅢ평분고，대존재이상위험인소적환자입원후요주의MODS적발생。
Objective To investigate the risk factors for multiple trauma patients with mutiple organ dyfunction syndrome(MODS),and to provide the references for clinical diagnosis and treatment .Methods A retrospective analysis on the clinical data of 154 multiple trauma patients was conducted .The 154 patients were divided into MODS group (84 cases) and non-MODS group (70 cases) according to the occurrence of MODS .The relevant factors were analyzed . Results The rate of shock being adjusted within 6 hours after admission ,Glasgow coma score ( GCS) score,red blood cell count and platelet count in MODS group were significantly lower than those in non-MODS group(P<0.05).However, patient′s age,injury severity score (ISS) score,APACHEⅢscore,white blood cell count,random blood glucose in MODS group were significantly higher than those in non-MODS group ( P<0 .05 ) .The non-conditional multivariate logistic regression analysis showed that shock without being adjusted within 6 hours after admission , high ISS score , high APACHEⅢscore were independent risk factors for patients complicated with MODS (P <0.05).The mortality of MODS group was 55.95%,which was higher than that(14.29%) in non-MODS group(P<0.05).The mortality and incidence of MODS showed a positive correlation (P<0.05).Conclusion The major risk factors of multiple trauma patients with MODS are shock without being adjusted in time after admission,high ISS and APACHEⅢ scores.It should be paid attention to the patients who have the risk factors mentioned above after their admission in case of the occurrence of MODS .
