急腹症患者合并脓毒性休克的相关因素分析及诊治  

Analysis on the related factors of acute abdomen pain combined with septic shock and treatment measures

作　　者：鞠琴[1] 耿辉[2] 武巧元[3] 王立新[1] 

机构地区：[1]常州市中医医院急诊科,江苏常州213003 [2]常州市中医医院普外科,江苏常州213003 [3]常州市中医医院ICU,江苏常州213003

出　　处：《中华医院感染学杂志》2013年第17期4139-4140,4153,共3页Chinese Journal of Nosocomiology

基　　金：常州市科技基金项目(CJ20112012)

摘　　要：目的探讨影响急腹症合并脓毒性休克的相关因素,并予以相对应的措施进行治疗,以提高治疗效果。方法对2008年12月-2012年12月在医院治疗的49例急腹症合并脓毒性休克患者进行回顾性调查,对其发生的相关因素进行分析,并采取相对应的措施进行治疗。结果影响急腹症合并脓毒性休克的危险因素有入院时间长(>2h)、多种并发症(>2种)、高降钙素原、高乳酸、有脏器功能衰竭综合征、未进行手术治疗等有关(P<0.05);而与患者的年龄、性别、CRP、机械通气、抗菌药物使用无关;而采用logostic多因素进行危险因素分析,高降钙素原、高乳酸、有脏器功能衰竭综合征是发生急腹症合并脓毒性休克的高危险因素(P<0.05)。结论急腹症合并脓毒性休克与多种因素关系密切,临床针对性地进行及时早期规范治疗,可降低病死率,提高临床效果。OBJECTIVE To investigate the related factors of acute abdominal pain combined with septic shock andgive treatment with the appropriate measures, to improve the therapeutic effect. METHODS A retrospective inves-tigation on 49 patients with acute abdominal pain combined with septic shock enrolled from Dec 2008 to Dec 2012was performed, the related factors for occurrence were analyzed and appropriate measures were taken for treat-ment. RESULTS The risk factors that affected the acute abdominal pain with septic shock included the long admis-sion time （〉2 h）,a variety of complications （〉2 kinds）,high levels of procalcitonin and lactic acid,accompa-nied by viscera function failure syndrome, no surgery, etc （P〈 0. 05）; but it was not related to patient,s age,gender, CRP, mechanical ventilation, antibiotic use or not. When analyzed by mulitiple factor logistic regressionmethod,it was concluded that,high levels of procalcitonin and lactic acid, accompanied by viscera function failuresyndrome were the high risk factors of the occurrence of acute abdominal pain combined with septic shock（P =0. 025 ,0. 003 , 0. 031 respectively）. CONCLUSION Acute abdominal pain with septic shock is closely relatedto a number of factors. It is necessary to perform an early standard therapy clinically, to reduce the mortality andenhance the clinical effect.

关 键 词：急腹症 脓毒性休克 相关因素 诊治对策 

分 类 号：R181.32[医药卫生—流行病学]