脓毒性休克患者的病死率和危险因素研究  

Study on predictors of mortality and risk factors in patients with septic shock

作　　者：张淑文[1] 苏强[1] 王超[1] 阴赪宏[1] 王红[1] 王宝恩[1] 

机构地区：[1]首都医科大学附属北京友谊医院感染暨急救医学科,北京100050

出　　处：《创伤外科杂志》2007年第1期8-10,共3页Journal of Traumatic Surgery

基　　金：北京市科技计划重大项目(H020920020530)

摘　　要：目的探讨三级甲等医院的ICU脓毒性休克患者的病死率及死亡危险因素。方法采用多中心、前瞻性临床研究的方法,对2003～2005年333例脓毒性休克患者的临床资料,应用卡方自动交互检测对其死亡危险因素进行统计学分析。结果脓毒性休克病死率高达73．3％。其中男性155／211例(73．5％),女性89／122例(73．0％)。死亡组的年龄、APACHEⅡ评分、收缩压、舒张压、平均动脉压和24小时尿量与存活组有显著差异。随着功能障碍器官数目的增加,病死率逐渐升高。平均动脉压<45mmHg者预计死亡概率高,>60mmHg死亡概率降低。结论脓毒性休克患者平均动脉压是影响预后的重要指标,应用多巴胺的基础上应用多巴酚丁胺或去甲肾上腺素对患者的预后无影响。Objective To investigate the mortality and risk factors of septic shock in 11 intensive care units. Methods 333 patients with septic shock from 2003 to 2005 were studied prospectively. Chi-squared Automatic Interaction Detector （ CHAID ） was performed to identify risk factors associated with septic shock. Results The overall mortality of 73.3% was still high. The mortality of 211 male patients was 73.5% ,and that of 122 female patients was 73%. Patients with lower mean arterial blood pressure（ MAP） had a relative higher mortality. There were marked differences between survivor and non-survivor groups in age, APACHE Ⅱ, SBP, DBP, MAP and the number of organs with dysfunction etc. The more failure organs existed, the higher mortality occured. Conclusion The mean arterial blood pressure was the main risk factor in septic shock. In addition to the use of dopamine, treatment with either dobutamine or noradrenaline might not affect the prognosis of patients with septic shock.

关 键 词：脓毒性休克 死亡原因 病死率 

分 类 号：R605.971[医药卫生—急诊医学]