ICU脓毒症并发急性肾损伤患者预后危险因素分析  

Analysis on the prognostic risk factors in the patients with ICU sepsis complicated with acute renal injury

作　　者：陈洪英[1] 李爱琴[1] 杨丹丹 蒋永泼 CHEN Hongying;LI Aiqin;YANG Dandan;JIANG Yongpp(Department of Critical Care Medicine,Taizhou Hospital in Zhejiang Province,Taizhou 317000,China)

机构地区：[1]浙江省台州医院重症医学科,浙江台州317000

出　　处：《中国现代医生》2019年第1期9-12,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2017KY706)

摘　　要：目的探讨ICU脓毒症并发急性肾损伤患者预后危险因素分析。方法选择2016年1月～2018年5月在我院ICU入住的脓毒症合并急性肾损伤患者68例为研究对象。收集患者的一般资料、临床资料以及实验室结果,单因素及多因素分析影响患者预后的危险因素。结果 68例患者中21例患者存活,47例患者死亡。单因素分析结果显示:高龄、脓毒症病情严重、衰竭器官个数>2个、机械通气、低LDH、低白蛋白、高K^+、低CRP、低MAP、高APACHEⅡ是影响患者预后的危险因素(P<0.05);多因素分析结果显示:APACHEⅡ、年龄、机械通气、脓毒症休克、低蛋白血症、MAP、衰竭器官>2、K^+是患者不良预后的独立危险因素(P<0.05)。结论 ICU脓毒症并发急性肾损伤死亡率高,患者的年龄、病情严重程度、机械通气、MAP低、衰竭器官个数多、低蛋白血症、高K^+是影响患者预后的独立危险因素。Objective To investigate the prognostic risk factors of the patients with ICU sepsis complicated with acute renal injury.Methods A total of 68 patients with sepsis complicated with acute kidney injury who were admitted to the ICU in our hospital from January 2016 to May 2018 were selected as the study subjects.General patient information,clinical data,and laboratory results were collected.Univariate and multivariate analysis was used to analyze the risk factors affecting patient's prognosis.Results Of the 68 patients,21 survived and 47 died.Univariate analysis showed that the age,severity of sepsis,number of organs with failure >2,mechanical ventilation,low LDH,low albumin,high K^+,low CRP,low MAP,and high APACHEⅡare the risk factors affecting patient's prognosis(P<0.05).Multivariate analysis showed that APACHEⅡ,age,mechanical ventilation,septic shock,hypoproteinemia,MAP,and depleted organs >2,and K^+were independent risk factors of patient's poor prognosis(P<0.05).Conclusion ICU sepsis complicated with acute renal injury has a high mortality rate.The age,severity of illness,mechanical ventilation,low MAP,multiple organs of failure,hypoproteinemia and high K^+are independent risk factors affected patient's prognosis.

关 键 词：ICU 脓毒症 急性肾损伤 预后 

分 类 号：R459.7[医药卫生—急诊医学]