中度高原地区急危重症ICU监护中的某些特征性变化  

Diagnostic Changes in Vital Signs of ICU Patients in Midrange Plateau Area

作　　者：陆皓[1] 戴飞[2] 安娟[1] 刘传兰[3] 

机构地区：[1]兰州军区兰州总医院护理部,兰州730050 [2]兰州军区兰州总医院统计室,兰州730050 [3]兰州军区兰州总医院ICU,兰州730050

出　　处：《临床误诊误治》2012年第7期74-76,共3页Clinical Misdiagnosis & Mistherapy

基　　金：甘肃省科技支撑计划项目(1104FKCA069)

摘　　要：目的探讨中度高原地区急危重症患者的临床表现和多脏器功能监护中的特征性变化,以降低患者的病死率。方法根据病因、原发病/伤和慢性病所致的多脏器功能损害情况,将我院ICU收治的98例急危重症分为创伤组(49例)、感染组(24例)和多脏器功能障碍组(25例)。监测项目包括血气指标,生化指标以及血、尿、便常规和相关特殊检查,均按照Marshall多脏器功能障碍综合征(MODS)评分分级标准(平原标准)及高原地区多脏器功能评分分级标准(兰州标准)进行评分,并对所获得数据进行统计学分析。结果本研究显示3组各脏器疾病分布大体均衡,具有可比性;在肺部功能状态(低氧血症)方面兰州标准评分明显高于平原标准,差异有统计学意义(P=0.0013);不同转归情况下兰州标准评分显示脑损伤方面比较差异有统计学意义(P=0.0051)。结论急危重症患者在ICU监护中将肺脏功能评分(氧合指数评分)调整后的兰州标准评分与平原标准区别开来更符合实际要求,但脑损害评价重于平原标准。Objective To explore the changes of clinical manifestation and multiorgan functional custody of ICU patients in midrange plateau area in order to reduce tatality rate. Methods According to conditions of multi-organ dysfunction for functional lesion etiological factor, primary disease/injury and chronic disease, three groups were established： trauma group （group A, n = 49）; infection group （group B, n =24） and multi-organs dysfunction group （group C, n = 25）. Based on Marshall muhiple organ dysthnction score （MODS） in plains criteria and multiple organ dysfunction score iu plateau criteria （Lanzhou criteria）, the data of Blood Gas Index, Biochemical Index, blood, urine, stool routine examinations and relative special examinations were statistically analyzed. Results The distribution of disease of the three groups were generally balanced and comparable. The functional status score of bellows （hyoxemia） in plateau （Lanzhou criteria） was statistically higher than that in plain area MODS （P = 0.0013 ） ; and the compared score of brain damage uuder different turnover condition in Lanzhou criteria showed statistical significance （P = 0. 0051 ）. Conclusion In ICU custodial care, the patient＇s scores of lung function criteria under adjusted oxygen index at Lanzhou criteria are delimitate from plain MODS, and it shows more reality. The brain damage at the plateau is severer than that in the plain area.

关 键 词：高原 危重病 重症监护病房 多脏器功能障碍综合征 疾病特征 

分 类 号：R459.7[医药卫生—急诊医学]