急性胃肠穿孔继发脓毒症的临床特征和预后影响因素评价  

Clinical Characteristics and Prognostic Factors of Sepsis Secondary to Acute Gastrointestinal Perforation

作　　者：冒东林 耿永勇 MAO Dong-lin;GENG Yong-yong(Department of Emergency Surgery,People＇s Hospital of Tumushuke City,Tumushuke,Xinjiang,843900 China)

机构地区：[1]新疆图木舒克市人民医院急诊外科,新疆图木舒克843900

出　　处：《中外医疗》2018年第19期82-83,89,共3页China & Foreign Medical Treatment

摘　　要：目的探讨急性胃肠穿孔继发脓毒症的临床特征,评估影响其预后效果的因素。方法方便选取2015年1月—2018年2月期间在该院接受治疗的50例胃肠穿孔患者,依照是否产生脓毒症分为胃肠穿孔伴脓毒症组(观察组)和胃肠穿孔不伴脓毒症组(空白组)。比较两组患者一般资料与各项指标检查结果。结果入组50例病例中,继发脓毒症20例(40.0%);观察组患者年龄(67.5±10.2)岁、血糖(6.8±2.4)mmol/L、乳酸(3.0±1.4)mmol/L、SOFA评分(5.7±3.3)分,总住院时间(36.74±5.4)d,与对照组对应值(55.4±10.7)岁、(5.8±1.3)mmol/L、(1.4±0.8)mmol/L、(0.6±0.5)分、(13.54±2.4)d相比,差异有统计学意义(t=4.210,4.347,8.457,12.014,11.254,P<0.05)。回归分析结果表明,MAP与GCS评分是胃肠穿孔合并脓毒症者死亡的独立危险因素。结论胃肠穿孔患者脓毒症发病率较高,且风险因素相对较多,只有采取降低MAP与GCS评分的相关措施,才有可能优化患者生存质量。Objective This paper tries to investigate the clinical characteristics of acute gastrointestinal perforation secondary sepsis, and to evaluate the prognostic factors. Methods 50 patients with gastrointestinal perforation who were treated in the hospital between January 2015 and February 2018 were convenient selected and classified into gastrointestinal perforation with sepsis group（observation group） and gastrointestinal perforation according to whether sepsis was produced or not.Sepsis group（blank group）. Compare the general data of the two groups with the results of the various indicators. Results Among the 50 patients enrolled, 20 patients（40.0%） were secondary to sepsis; the patients in the observation group were（67.5 ±10.2）years old, blood glucose（6.8 ±2.4）mmol/L, lactic acid（3.0 ±1.4）mmol/L, and SOFA scores（5.7 ±3.3）points, total hospital stay（36.74±5.4）days, corresponding to the control group（55.4±10.7）years,（5.8±1.3）mmol/L,（1.4±0.8）mmol/L,（0.6±0.5）points,（13.54±2.4）d, the difference was statistically significant（t=4.210, 4.347, 8.457, 12.014,11.254,P〈0.05）. Regression analysis results showed that MAP and GCS scores were independent risk factors for gastrointestinal perforation with sepsis. Conclusion The incidence of sepsis in patients with gastrointestinal perforation is high, and the risk factors are relatively high. Only by taking relevant measures to reduce MAP and GCS scores can it be possible to optimize the quality of life of patients.

关 键 词：急性胃肠穿孔 脓毒症 临床特征 预后 影响因素 

分 类 号：R5[医药卫生—内科学]