CAJ | 학술논문

目的探讨脓毒症患者并发脓毒性脑病的危险因素,为脓毒性脑病的早期发现提供参考.方法以中国医科大学附属盛京医院急诊科2009年3月—2012年3月收治的110例脓毒症患者为研究对象,并利用HIS系统,对110例脓毒症患者转入病区治疗后的临床资料进行回顾性分析,采用单因素分析,并结合统计学的分析方法,对影响脓毒性脑病发生和死亡的危险因素进行探讨.结果脓毒性脑病的发病率为51.39%;入院患者的年龄、吸烟史、电解质紊乱、高脂血症、高乳酸血症、糖尿病、凝血功能障碍以及APACHEⅡ评分值与发生脓毒性脑病的关联性较大.通过对以上引发脓毒性脑病的危险因素做多元线性回归分析可以得出：APACHEⅡ评分值〉20、糖尿病和凝血功能障碍是脓毒性脑病发病的独立危险因素.结论脓毒性脑病发病率和死亡率较高,目前还没有针对此病的特殊治疗方法,因此,应对APACHEⅡ评分值〉20、伴有糖尿病和凝血功能障碍的患者进行密切观察,争取能够做到对脓毒性脑病患者进行早期治疗,进而降低治疗成本,提高脓毒症患者的生存率.
목적탐토농독증환자병발농독성뇌병적위험인소,위농독성뇌병적조기발현제공삼고.방법이중국의과대학부속성경의원급진과2009년3월—2012년3월수치적110례농독증환자위연구대상,병이용HIS계통,대110례농독증환자전입병구치료후적림상자료진행회고성분석,채용단인소분석,병결합통계학적분석방법,대영향농독성뇌병발생화사망적위험인소진행탐토.결과농독성뇌병적발병솔위51.39%;입원환자적년령、흡연사、전해질문란、고지혈증、고유산혈증、당뇨병、응혈공능장애이급APACHEⅡ평분치여발생농독성뇌병적관련성교대.통과대이상인발농독성뇌병적위험인소주다원선성회귀분석가이득출：APACHEⅡ평분치〉20、당뇨병화응혈공능장애시농독성뇌병발병적독립위험인소.결론농독성뇌병발병솔화사망솔교고,목전환몰유침대차병적특수치료방법,인차,응대APACHEⅡ평분치〉20、반유당뇨병화응혈공능장애적환자진행밀절관찰,쟁취능구주도대농독성뇌병환자진행조기치료,진이강저치료성본,제고농독증환자적생존솔.
Objective To investigate the risk factors of sepsis patients complicated with septic encephalopathy,to give a reference method for the early detection and treatment of septic encephalopathy.Method 110 Cases of sepsis patients received and cured in the emergency department of our hospital during March 2009 to March 2012 were taken as the research objects,HIS system was used to make a retrospective analysis on the clinical data from 110 cases of sepsis patients after they were transferred to the ward,and the single factor analysis combined with statistical analysis method was applied todiscuss the risk factors affecting the occurrence and death of septic encephalopathy.Results The incidence of septic encephalopathy was 51.39%;some factors,such as the age,smoking history,electrolyte disorders,high blood lipid,lactic acidosis,diabetes mellitus,blood coagulation dysfunction and APACHEⅡscore values of the patients in hospital were relatively more associated with the occurrence of septic encephalopathy.The linear regression analysis of the above risk factors to induce septic encephalopathy showed that the values of APACHE Ⅱscores were 20,and diabetes and blood coagulation dysfunction were independent risk factors affecting the morbidity of septic encephalopathy.Conclusion The morbidity and mortality of septic encephalopathy is high and there has been no special treatment for this disease yet so that we should observe closely the patients with APACHEⅡscore values more than 20,diabetes and blood coagulation dysfunction,and strive to treat the patients with septic encephalopathy earlier,reduce the cost of treatment,and improve the survival rate of sepsis patients.