中华危重病急救医学
中華危重病急救醫學
중화위중병급구의학
Chinese Critical Care Medicine
2015年
8期
635-638
,共4页
苗利辉%宋青%刘辉%周飞虎%康红军%潘亮%胡婕%陈洁坤%张婷%吴振华%赵佳佳%周京江
苗利輝%宋青%劉輝%週飛虎%康紅軍%潘亮%鬍婕%陳潔坤%張婷%吳振華%趙佳佳%週京江
묘리휘%송청%류휘%주비호%강홍군%반량%호첩%진길곤%장정%오진화%조가가%주경강
热射病%胃肠道功能%急性生理学与慢性健康状况评分系统Ⅱ评分%病死率%预后
熱射病%胃腸道功能%急性生理學與慢性健康狀況評分繫統Ⅱ評分%病死率%預後
열사병%위장도공능%급성생이학여만성건강상황평분계통Ⅱ평분%병사솔%예후
Heat stroke%Gastrointestinal function%Acute physiology and chronic health evaluationⅡscore%Mortality%Prognosis
目的：探讨热射病（HS）患者胃肠道功能障碍与病情严重程度及预后的关系。方法采用回顾性研究方法，选择2013年1月至2014年9月解放军总医院重症医学科参与救治的39例HS患者的临床资料，根据患者是否发生胃肠功能障碍分为胃肠道功能障碍组和非胃肠道功能障碍组。比较两组患者入院24 h内急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分及28 d病死率。统计胃肠道功能障碍患者胃肠道功能障碍评分、胃肠道功能障碍持续时间、重症加强治疗病房（ICU）住院时间及呼吸机使用时间，并对胃肠道功能与病情严重程度及预后指标进行Pearson相关性分析。结果39例HS患者中有32例发生胃肠道功能障碍，发生率为82.05%。共统计到27例胃肠道功能障碍患者的胃肠道功能障碍评分，为（2.3±0.8）分；39例HS胃肠功能障碍患者胃肠道功能障碍持续时间为（17.3±15.2）d，ICU住院时间为（37.8±25.0）d，呼吸机使用时间为（27.8±14.0）d。胃肠道功能障碍组APACHEⅡ评分显著高于非胃肠道功能障碍组（分：26.30±6.00比17.40±6.00，t＝3.555，P＝0.001），而28 d病死率虽高于非胃肠道功能障碍组，但差异无统计学意义〔43.75%（14/32）比14.29%（1/7），P＝0.216〕。Pearson相关分析显示，HS胃肠道功能障碍患者胃肠道功能障碍评分与APACHEⅡ评分呈显著正相关（r＝0.727，P＝0.000）；胃肠道功能障碍持续时间与ICU住院时间（r＝0.797， P＝0.000）及呼吸机使用时间（r＝0.634，P＝0.000）均呈显著正相关。结论胃肠道功能可反映HS患者病情严重程度及预后。
目的：探討熱射病（HS）患者胃腸道功能障礙與病情嚴重程度及預後的關繫。方法採用迴顧性研究方法，選擇2013年1月至2014年9月解放軍總醫院重癥醫學科參與救治的39例HS患者的臨床資料，根據患者是否髮生胃腸功能障礙分為胃腸道功能障礙組和非胃腸道功能障礙組。比較兩組患者入院24 h內急性生理學與慢性健康狀況評分繫統Ⅱ（APACHEⅡ）評分及28 d病死率。統計胃腸道功能障礙患者胃腸道功能障礙評分、胃腸道功能障礙持續時間、重癥加彊治療病房（ICU）住院時間及呼吸機使用時間，併對胃腸道功能與病情嚴重程度及預後指標進行Pearson相關性分析。結果39例HS患者中有32例髮生胃腸道功能障礙，髮生率為82.05%。共統計到27例胃腸道功能障礙患者的胃腸道功能障礙評分，為（2.3±0.8）分；39例HS胃腸功能障礙患者胃腸道功能障礙持續時間為（17.3±15.2）d，ICU住院時間為（37.8±25.0）d，呼吸機使用時間為（27.8±14.0）d。胃腸道功能障礙組APACHEⅡ評分顯著高于非胃腸道功能障礙組（分：26.30±6.00比17.40±6.00，t＝3.555，P＝0.001），而28 d病死率雖高于非胃腸道功能障礙組，但差異無統計學意義〔43.75%（14/32）比14.29%（1/7），P＝0.216〕。Pearson相關分析顯示，HS胃腸道功能障礙患者胃腸道功能障礙評分與APACHEⅡ評分呈顯著正相關（r＝0.727，P＝0.000）；胃腸道功能障礙持續時間與ICU住院時間（r＝0.797， P＝0.000）及呼吸機使用時間（r＝0.634，P＝0.000）均呈顯著正相關。結論胃腸道功能可反映HS患者病情嚴重程度及預後。
목적：탐토열사병（HS）환자위장도공능장애여병정엄중정도급예후적관계。방법채용회고성연구방법，선택2013년1월지2014년9월해방군총의원중증의학과삼여구치적39례HS환자적림상자료，근거환자시부발생위장공능장애분위위장도공능장애조화비위장도공능장애조。비교량조환자입원24 h내급성생이학여만성건강상황평분계통Ⅱ（APACHEⅡ）평분급28 d병사솔。통계위장도공능장애환자위장도공능장애평분、위장도공능장애지속시간、중증가강치료병방（ICU）주원시간급호흡궤사용시간，병대위장도공능여병정엄중정도급예후지표진행Pearson상관성분석。결과39례HS환자중유32례발생위장도공능장애，발생솔위82.05%。공통계도27례위장도공능장애환자적위장도공능장애평분，위（2.3±0.8）분；39례HS위장공능장애환자위장도공능장애지속시간위（17.3±15.2）d，ICU주원시간위（37.8±25.0）d，호흡궤사용시간위（27.8±14.0）d。위장도공능장애조APACHEⅡ평분현저고우비위장도공능장애조（분：26.30±6.00비17.40±6.00，t＝3.555，P＝0.001），이28 d병사솔수고우비위장도공능장애조，단차이무통계학의의〔43.75%（14/32）비14.29%（1/7），P＝0.216〕。Pearson상관분석현시，HS위장도공능장애환자위장도공능장애평분여APACHEⅡ평분정현저정상관（r＝0.727，P＝0.000）；위장도공능장애지속시간여ICU주원시간（r＝0.797， P＝0.000）급호흡궤사용시간（r＝0.634，P＝0.000）균정현저정상관。결론위장도공능가반영HS환자병정엄중정도급예후。
ObjectiveTo investigate the relationship between gastrointestinal dysfunction and both severity and prognosis in patients with heatstroke (HS).Methods A retrospective analysis was conducted. Clinical data from 39 patients with HS seeking for treatment in Department of Critical Care Medicine of Chinese PLA General Hospital from January 2013 to September 2014 were enrolled. The patients were divided into two groups: gastrointestinal dysfunction group and non-gastrointestinal dysfunction group. The acute physiology and chronic health evaluationⅡ(APACHEⅡ) score within 24 hours of admission and 28-day mortality were compared between two groups. In gastrointestinal dysfunction group, the gastrointestinal dysfunction score, the duration days of gastrointestinal dysfunction, the length of intensive care unit (ICU) stay, and the duration of mechanical ventilation were collected. Pearson correlation analysis was used to analyze the relationship between gastrointestinal function and the severity of the ailment as well as the prognosis.Results Among 39 patients with HS, 32 of them showed gastrointestinal dysfunction with an incidence of 82.05%. In gastrointestinal dysfunction group, the gastrointestinal dysfunction score was 2.3±0.8, the duration of gastrointestinal dysfunction was (17.3±15.2) days, the length of ICU stay was (37.8±25.0) days, and the duration of mechanical ventilation was (27.8±14.0) days. APACHEⅡ score in gastrointestinal dysfunction group was significantly higher than that of the non-gastrointestinal dysfunction group (26.30±6.00 vs. 17.40±6.00, t = 3.555,P = 0.001). The 28-day mortality in gastrointestinal dysfunction group was slightly higher than that of the non-gastrointestinal dysfunction group without statistically significant difference [43.75% (14/32) vs. 14.29% (1/7),P = 0.216]. It was shown by Pearson analysis that gastrointestinal dysfunction score was positively correlated with APACHEⅡ score (r = 0.727,P = 0.000), and the duration of gastrointestinal dysfunction was positively correlated with the length of ICU stay (r = 0.797,P = 0.000) and the duration of mechanical ventilation (r = 0.634,P = 0.000). Conclusion The results suggest that gastrointestinal function in patients with HS reflects the severity and prognosis of the ailment.
