浙江医学
浙江醫學
절강의학
ZHEJIANG MEDICAL JOURNAL
2013年
7期
550-552
,共3页
高钠血症%颅脑损伤%死亡危险因素
高鈉血癥%顱腦損傷%死亡危險因素
고납혈증%로뇌손상%사망위험인소
Hypernatremia%Traumatic brain injury%Risk factors for mortality
目的探讨不同程度高钠血症与颅脑损伤患者死亡的相关风险.方法将近5年ICU的颅脑损伤患者431例根据血钠水平分为4组,非高钠组(<150mmol/L)、轻度高钠组(150~155mmol/L)、中度高钠组(155~160 mmol/L)、重度高钠组(≥160mmol/L),分析血钠水平与患者死亡的相关风险.结果重度高钠组患者的Glasgow昏迷评分(GCS)3.27±0.89,APACHE-II评分35.25±6.01,病死率93.82%,与轻、中度高钠组患者相比,具有统计学差异(P<0.05).Logistic多因素分析提示GCS评分下降(OR=3.96,95%CI=1.43~10.96,P<0.05),APACHE-II评分升高(OR=1.32,95%CI=1.21~1.41,P<0.05)和重度高钠血症(OR=6.07,95%CI=3.19~13.87,P<0.05)是颅脑损伤患者的死亡危险因素.结论重度高钠血症是脑外伤患者死亡的主要危险因素之一.
目的探討不同程度高鈉血癥與顱腦損傷患者死亡的相關風險.方法將近5年ICU的顱腦損傷患者431例根據血鈉水平分為4組,非高鈉組(<150mmol/L)、輕度高鈉組(150~155mmol/L)、中度高鈉組(155~160 mmol/L)、重度高鈉組(≥160mmol/L),分析血鈉水平與患者死亡的相關風險.結果重度高鈉組患者的Glasgow昏迷評分(GCS)3.27±0.89,APACHE-II評分35.25±6.01,病死率93.82%,與輕、中度高鈉組患者相比,具有統計學差異(P<0.05).Logistic多因素分析提示GCS評分下降(OR=3.96,95%CI=1.43~10.96,P<0.05),APACHE-II評分升高(OR=1.32,95%CI=1.21~1.41,P<0.05)和重度高鈉血癥(OR=6.07,95%CI=3.19~13.87,P<0.05)是顱腦損傷患者的死亡危險因素.結論重度高鈉血癥是腦外傷患者死亡的主要危險因素之一.
목적탐토불동정도고납혈증여로뇌손상환자사망적상관풍험.방법장근5년ICU적로뇌손상환자431례근거혈납수평분위4조,비고납조(<150mmol/L)、경도고납조(150~155mmol/L)、중도고납조(155~160 mmol/L)、중도고납조(≥160mmol/L),분석혈납수평여환자사망적상관풍험.결과중도고납조환자적Glasgow혼미평분(GCS)3.27±0.89,APACHE-II평분35.25±6.01,병사솔93.82%,여경、중도고납조환자상비,구유통계학차이(P<0.05).Logistic다인소분석제시GCS평분하강(OR=3.96,95%CI=1.43~10.96,P<0.05),APACHE-II평분승고(OR=1.32,95%CI=1.21~1.41,P<0.05)화중도고납혈증(OR=6.07,95%CI=3.19~13.87,P<0.05)시로뇌손상환자적사망위험인소.결론중도고납혈증시뇌외상환자사망적주요위험인소지일.
@@@@Objective To investigate the relationship between hypernatremia and the mortality risk for patients with trau-matic brain injury (TBI). Methods Fours hundred and thirty one patients with TBI were enrolled in the study. Based on blood serum sodium level patients were divided into four groups:noon-hypernatremia (serum sodium<150mmol/L), mild hypernatrem-ia (serum sodium:150~155mmol/L), moderate hypernatremia (serum sodium: 155~160mmol/L) and severe hypernatremia (serum sodium≥160mmol/L). The risk of mortality with the serum sodium levels was analyzed. Results Severe hypernatremia groups had the lowest Glasgow Coma Scale (3.27±0.89) and the highest APACHE-II Scale (35.25±6.01) with a mortality rate of 93.82%. Logistic regression multivariable analysis showed that the decreased Glasgow Coma Scale (OR=3.96, 95%CI=1.43~10.96, P<0.05), increased APACHE-II Scale (OR=1.32, 95%CI=1.2~1.41, P<0.05) and severe hypernatremia (OR=6.07, 95%CI=3.19~13.87, P<0.05) were major risk factors for mortality of TBI patients. Conclusion Severe hypernatremia is a major risk factor for mortality of patients with traumatic brain injury.
