影响ICU危重病患者预后的危险因素探讨  

Risk Factors Influencing Prognoses of Critically-ill Patients in ICU

作　　者：董丽宏[1] 

机构地区：[1]昆明医学院第一附属医院ICU,云南省昆明市650032

出　　处：《中国全科医学》2010年第35期4030-4032,共3页Chinese General Practice

摘　　要：目的探讨影响ICU危重病患者预后的相关危险因素。方法选择我院ICU收治的危重病患者152例,根据患者的预后分为存活组(106例)和死亡组(46例),采用单因素分析和多因素逐步Logistic回归,探讨影响危重病患者预后的相关危险因素。结果两组患者住ICU时间、平均动脉压、急性生理学和慢性健康状况系统(A-PACHE-II)评分、pH值、二氧化碳分压、Ca2+、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、乳酸、C-反应蛋白、肌酐、尿素氮、硫化氢、低钙血症发生率、有创诊疗及机械通气时间比较,差异均有统计学意义(P<0.05)。进一步Logistic回归分析,结果发现住ICU时间、APACHE-II评分、Ca2+、乳酸、有创诊疗及机械通气时间是影响危重病患者预后的独立因素。结论住ICU时间、APACHE-II评分、Ca2+、乳酸、有创诊疗及机械通气时间可作为判断危重病患者预后的参考指标,危重病患者充分评估上述影响因素,根据病情采取积极干预措施,对降低病死率非常重要。Objective To explore the risk factors influencing prognoses of critically-ill patients in intensive care unit（ICU）.Methods One hundred fifty-two critically-ill patients admitted to ICU of our hospital were divided,according to prognosis,into groups survival（n=106）and death（n=46）.The risk factors influencing the prognoses were studied by univariate and Logistic regression analysis.Results There was significant difference between 2 groups in ICU stay,mean arterial pressure,acute physiology and chronic health evaluation（APACHE Ⅱ）,pH value,carbon dioxide partial pressure,Ca^2＋,alanine aminotransferase,aspartate aminotransferase,lactate,C-reactive protein,creatinine,uric acid nitrogen,hydrogen sulfide,hypocalcemia incidence,time of invasive treatment and mechanical ventilation（P〈0.05）.A further Logistic regression analysis showed that ICU stay,APACHE-Ⅱ,Ca^2＋,lactic acid,invasive treatment and time of mechanical ventilation were independent factors influencing prognoses of critically-ill patients.Conclusion ICU stay,APACHE-Ⅱ,Ca^2＋,lactic acid,invasive treatment and mechanical ventilation,which can be used as reference indexes for prognoses of critically-ill patients,should be fully assessed and active intervention measures be taken according to patients＇ condition,which is of great significance to lowering mortality.

关 键 词：危重病 预后 危险因素 

分 类 号：R473.52[医药卫生—护理学]