脓毒性休克患者急性静脉血栓栓塞发病情况及其与病情和预后的关系  

Incidence of Acute Venous Thromboembolism among Patients with Septic Shock and Its Relationships to Disease Condition and Prognosis

作　　者：尚宝朋 李彦德 麦志伟 李志波[1] SHANG Bao-peng;LI Yan-de;MAI Zhi-wei;LI Zhi-bo(Department of Critical Care Medicine,Chenxinghai Hospital of Zhongshan,Zhongshan 528415,China)

机构地区：[1]中山市陈星海医院重症医学科

出　　处：《南昌大学学报（医学版）》2019年第4期47-49,68,共4页Journal of Nanchang University：Medical Sciences

基　　金：广东省中山市卫生局项目(2018J251)

摘　　要：目的分析脓毒性休克患者急性静脉血栓栓塞(VTE)的发病情况及其与病情和预后的关系。方法选取确诊的脓毒性休克患者106例进行前瞻性研究,观察患者是否发生VTE并根据是否发生VTE将患者分为VTE组(n=41)和非VTE组(n=65)。统计2组患者的基线资料、APACHEⅡ评分和预后情况,并采用logistic分析法分析脓毒性休克患者VTE发病情况及其与病情和预后的关系。结果脓毒性休克患者发生VTE的发病率为38.67%,VTE组患者的APACHEⅡ评分和28 d病死率明显高于、住院时间明显长于非VTE组(均P<0.05),身体质量指数(BMI)则明显低于非VTE组(P<0.05)。患者的VTE的发病率与其APACHEⅡ评分和28 d病死率有明显相关关系(r=8.452、r=8.441,均P<0.05),与其BMI和住院时间无关(r=1.133、r=1.038,均P>0.05)。结论脓毒性休克患者中VTE的发病率较高,与其APACHEⅡ评分和28 d病死率存在明显的相关关系,根据是否发生VTE可为评估脓毒性休克患者病情和预后提供帮助。Objective To analyze the incidence of acute venous thromboembolism(VTE)among patients with septic shock and its relationships to disease condition and prognosis.Methods A prospective study was conducted on 106 patients with confirmed septic shock.These patients were divided into two groups:VTE group(n=41)and non-VTE group(n=65).Baseline data,APACHEⅡscore and prognosis were analyzed in both groups.In addition,the relationships of the incidence of VTE to disease condition and prognosis were analyzed by logistic regression analysis.Results The incidence of VTE was 38.67%among patients with septic shock.Compared with non-VTE group,APACHEⅡscore,28-day case fatality rate and hospital stay increased while body mass index(BMI)decreased in VTE group(P<0.05).The incidence of VTE was obviously correlated with APACHEⅡscore and 28-day case fatality rate(r=8.452 and 8.441,respectively;P<0.05),but was not related to BMI and hospital stay(r=1.133 and 1.038,respectively;P>0.05).Conclusion Patients with septic shock has a high incidence of VTE,which is correlated with APACHEⅡscore and 28-day case fatality rate.Therefore,the occurrence of VTE may be helpful for evaluating the condition and prognosis of patients with septic shock.

关 键 词：脓毒性休克 急性静脉血栓栓塞 病情 预后 

分 类 号：R515.3[医药卫生—内科学]