创伤后多器官功能障碍综合征预后影响因素分析  

Factors influencing prognosis of multiple organ dysfunction syndrome after trauma

作　　者：邵志江[1] 沈建伟[1] 贾惠娟[1] 

机构地区：[1]天津市第五中心医院,天津300450

出　　处：《山东医药》2014年第27期18-20,共3页Shandong Medical Journal

基　　金：天津市卫生局科技基金资助项目(2012KZ016)

摘　　要：目的分析创伤后多器官功能障碍综合征(MODS)预后影响因素。方法创伤后发生MODS患者66例,按转归分为存活组(47例)和病死组(19例),先对两组的各项临床指标进行单因素分析,对单因素分析显示有统计学意义的影响因素行多因素Logistic回归分析。结果单因素分析结果显示,年龄(t=5.490,P=0.019)、体温(t=3.781,P=0.049)、血尿素氮水平(t=7.537,P=0.006)、血白蛋白水平(t=6.089,P=0.014)、中心静脉压(t=6.033,P=0.014)、是否存在致死性三联征(χ2=18.510,P=0.001)、MODS器官是否≥3(χ2=5.533,P=0.019)、是否合并肺感染(χ2=5.676,P=0.017)、Glasgow值(μ=1 309.500,P=0.000)与预后相关。Logistic回归分析显示,血白蛋白水平(β1=-0.766,P=0.023)、中心静脉压(β2=-4.179,P=0.016)、年龄(β3=0.977,P=0.043)、血尿素氮水平(β4=4.474,P=0.027)是预后独立影响因素。结论创伤后多器官功能障碍综合征预后影响因素主要有血白蛋白水平、中心静脉压、年龄、血尿素氮水平。Objective To analyze the factors influencing the prognosis of multiple organ dysfunction syndrome （MODS） after trauma.Methods Sixty-six patients who appeared MODS after trauma were divided into two groups： the survival group （47 cases） and death group （19 cases）.At first, we studied the various clinical indicators with univariate regression analysis between the two groups .Then, the clinical indicators with statistical significant differences were led to the multivariate logistic regression analysis .Results Univariate analysis revealed that the factors impacting the prognosis were age （t=5.490, P=0.019）, temperature （t =3.781, P=0.049）, blood urea nitrogen level （t=7.537, P=0.006）, serum albumin level （t=6.089, P=0.014）, central venous pressure （t=6.033, P=0.014）, Glasgow （μ=1309.500, P=0.000）, and whether there was lethal triad of death （χ2 =18.510, P=0.001）,whether the MODS organs were 3 or higher （χ2 =5.533, P=0.019）,whether they were complicated with pulmonary infection （χ2 =5.676,P=0.017）.Logistic regression analysis showed that the serum albumin level （β1 =-0.766, P=0.023）, central venous pressure （β2 =-4.179, P=0.016）, age （β3 =0.977, P=0.043）and blood urea nitrogen （β4 =4.474, P=0.027） were the independent factors .Conclusion The factors influencing of the prognosis of MODS are serum albumin level , central venous pressure , age and blood urea nitrogen level .

关 键 词：多器官功能障碍综合征 创伤 病死率 

分 类 号：R641[医药卫生—外科学]