山东医药
山東醫藥
산동의약
SHANDONG MEDICAL JOURNAL
2014年
27期
18-20
,共3页
多器官功能障碍综合征%创伤%病死率
多器官功能障礙綜閤徵%創傷%病死率
다기관공능장애종합정%창상%병사솔
multiple organ dysfunction syndrome%trauma%mortality
目的:分析创伤后多器官功能障碍综合征( MODS)预后影响因素。方法创伤后发生MODS患者66例,按转归分为存活组(47例)和病死组(19例),先对两组的各项临床指标进行单因素分析,对单因素分析显示有统计学意义的影响因素行多因素Logistic回归分析。结果单因素分析结果显示,年龄(t=5.490,P=0.019)、体温(t=3.781,P=0.049)、血尿素氮水平(t=7.537,P=0.006)、血白蛋白水平(t=6.089,P=0.014)、中心静脉压(t=6.033,P=0.014)、是否存在致死性三联征(χ2=18.510,P=0.001)、MODS 器官是否≥3(χ2=5.533,P =0.019)、是否合并肺感染(χ2=5.676,P=0.017)、Glasgow值(μ=1309.500,P=0.000)与预后相关。 Logistic回归分析显示,血白蛋白水平(β1=-0.766,P=0.023)、中心静脉压(β2=-4.179,P=0.016)、年龄(β3=0.977,P=0.043)、血尿素氮水平(β4=4.474,P=0.027)是预后独立影响因素。结论创伤后多器官功能障碍综合征预后影响因素主要有血白蛋白水平、中心静脉压、年龄、血尿素氮水平。
目的:分析創傷後多器官功能障礙綜閤徵( MODS)預後影響因素。方法創傷後髮生MODS患者66例,按轉歸分為存活組(47例)和病死組(19例),先對兩組的各項臨床指標進行單因素分析,對單因素分析顯示有統計學意義的影響因素行多因素Logistic迴歸分析。結果單因素分析結果顯示,年齡(t=5.490,P=0.019)、體溫(t=3.781,P=0.049)、血尿素氮水平(t=7.537,P=0.006)、血白蛋白水平(t=6.089,P=0.014)、中心靜脈壓(t=6.033,P=0.014)、是否存在緻死性三聯徵(χ2=18.510,P=0.001)、MODS 器官是否≥3(χ2=5.533,P =0.019)、是否閤併肺感染(χ2=5.676,P=0.017)、Glasgow值(μ=1309.500,P=0.000)與預後相關。 Logistic迴歸分析顯示,血白蛋白水平(β1=-0.766,P=0.023)、中心靜脈壓(β2=-4.179,P=0.016)、年齡(β3=0.977,P=0.043)、血尿素氮水平(β4=4.474,P=0.027)是預後獨立影響因素。結論創傷後多器官功能障礙綜閤徵預後影響因素主要有血白蛋白水平、中心靜脈壓、年齡、血尿素氮水平。
목적:분석창상후다기관공능장애종합정( MODS)예후영향인소。방법창상후발생MODS환자66례,안전귀분위존활조(47례)화병사조(19례),선대량조적각항림상지표진행단인소분석,대단인소분석현시유통계학의의적영향인소행다인소Logistic회귀분석。결과단인소분석결과현시,년령(t=5.490,P=0.019)、체온(t=3.781,P=0.049)、혈뇨소담수평(t=7.537,P=0.006)、혈백단백수평(t=6.089,P=0.014)、중심정맥압(t=6.033,P=0.014)、시부존재치사성삼련정(χ2=18.510,P=0.001)、MODS 기관시부≥3(χ2=5.533,P =0.019)、시부합병폐감염(χ2=5.676,P=0.017)、Glasgow치(μ=1309.500,P=0.000)여예후상관。 Logistic회귀분석현시,혈백단백수평(β1=-0.766,P=0.023)、중심정맥압(β2=-4.179,P=0.016)、년령(β3=0.977,P=0.043)、혈뇨소담수평(β4=4.474,P=0.027)시예후독립영향인소。결론창상후다기관공능장애종합정예후영향인소주요유혈백단백수평、중심정맥압、년령、혈뇨소담수평。
Objective To analyze the factors influencing the prognosis of multiple organ dysfunction syndrome (MODS) after trauma.Methods Sixty-six patients who appeared MODS after trauma were divided into two groups: the survival group (47 cases) and death group (19 cases).At first, we studied the various clinical indicators with univariate regression analysis between the two groups .Then, the clinical indicators with statistical significant differences were led to the multivariate logistic regression analysis .Results Univariate analysis revealed that the factors impacting the prognosis were age (t=5.490, P=0.019), temperature (t =3.781, P=0.049), blood urea nitrogen level (t=7.537, P=0.006), serum albumin level (t=6.089, P=0.014), central venous pressure (t=6.033, P=0.014), Glasgow (μ=1309.500, P=0.000), and whether there was lethal triad of death (χ2 =18.510, P=0.001),whether the MODS organs were 3 or higher (χ2 =5.533, P=0.019),whether they were complicated with pulmonary infection (χ2 =5.676,P=0.017).Logistic regression analysis showed that the serum albumin level (β1 =-0.766, P=0.023), central venous pressure (β2 =-4.179, P=0.016), age (β3 =0.977, P=0.043)and blood urea nitrogen (β4 =4.474, P=0.027) were the independent factors .Conclusion The factors influencing of the prognosis of MODS are serum albumin level , central venous pressure , age and blood urea nitrogen level .