全身炎症反应综合征与老年胆源性休克病人死亡的相关性调查  

Correlation of Systemic Inflammatory Response Syndrome (SIRS) with Death of Cholangitis-originated Shock in the Aged

作　　者：周琨[1] 史计月[1] 张洪林[1] 侯宝君[1] 周家琳[1] 

机构地区：[1]河北工程学院临床医学院附属医院,河北邯郸056029

出　　处：《临床误诊误治》2005年第9期617-619,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的: 探讨全身炎症反应综合征(SIRS)与老年胆源性休克病人死亡的相关性.方法: 1994年1月～2005年1月间经治的年龄≥65岁,符合胆源性休克诊断标准的住院病人49例,其中痊愈出院31例(Ⅰ组),死亡18例(Ⅱ组),对比分析就诊时间、确诊时间、休克持续时间和开始手术时间等指标,同时应用SIRS评分和危重病人急性生理学与慢性健康评定标准Ⅱ(APACHE Ⅱ)评分评估入院4小时、12小时、24小时、48小时和96小时的病情演变.结果:①Ⅱ组较Ⅰ组病人在就诊时间、确诊时间、休克持续时间和开始手术时间等方面相比较,差别均有显著意义(P＜0.01);②各时间段SIRS、APACHE Ⅱ评分I组均显著低于Ⅱ组,只是入院4小时、12小时的APACHE Ⅱ评分指标参数不齐全,可比性受质疑,而同时间段SIRS指标参数中呼吸、白细胞计数比较,Ⅱ组病人分值显著高于Ⅰ组,认为是有意义的指标.结论: 老年胆源性休克病人均存在程度不同的SIRS,SIRS持续恶化是导致死亡的主要因素, SIRS评分有助于早期识别病情变化,明确诊断,降低病死率.Objective：To explore the correlations between Systemic Inflammatory Response Syndrome （SIRS） and the death due to cholangitis-originated shock in the aged. Methods ：49 cases of cholangitis-originated shock at the age of 65 or over were collected in ac- cordance with Criteria of Cholangitis - originated Shock and were hospitalized between January, in the year 1994 and January ,2005. They were divided in two groups：survival group （Group A）including 31 cases, recovered from the disease and death group containing 18 death cases （Group B）. Data on referral time, diagnosis time,operation time and duration of shock were recorded and analyzed. And SIRS Grading and APACHE Ⅱ Grading were used to grade their conditions and development at the 4th hour, the 12th hour, the 1 st day, 2nd days and the 4th day of the hospitalization. Results： 1. Group A was significantly different from Group B in referral time,time for confirmed diagnosis,interval before operation and duration of shock （P 〈 0.01 ） ：2. SIRS score and APACHE Ⅱ in group A greatly lower than those B at all other time points, except at 4th hour and 12th hour the SIRS and APACHE Ⅱ scores were not complete so they were less reliable. But among SIRS indexes,scores of respiration function and white cell count were much higher in Group B than in Group A. Conclusions：SIRS was present in the aged patients with cholangitis-originated shock at different degree and progressive deterioration of SIRS was the main factor of death. SIRS grading was helpful to valuation of the patients＇condition and the prognosis.

关 键 词：老年人 胆源性 休克 全身炎症反应综合征 评分 相关性调查 

分 类 号：R195[医药卫生—卫生统计学]