上消化道穿孔患者死亡的危险因素分析  

Risk factors of death in patients with upper gastrointestinal perforation

作　　者：李定云[1] 王婷 张涛[1] 赖家骏[1] 朱晓峰[1] 曾德强[1] 张小聪 LI Ding-yun;WANG Ting;ZHANG Tao(Department of Gastrointestinal Surgery,Yuebei People’s Hospital Affiliated to Shantou University,Shaoguan 512026,China)

机构地区：[1]汕头大学附属粤北人民医院胃肠外科,512026

出　　处：《中国实用医药》2020年第19期34-36,共3页China Practical Medicine

摘　　要：目的分析导致上消化道穿孔患者死亡的危险因素。方法回顾性分析180例上消化道穿孔患者的临床资料,统计其死亡情况,并采用单因素及Logistic多因素回归分析导致上消化道穿孔患者死亡的影响因素及危险因素。结果180例上消化道穿孔患者中死亡25例,死亡率为13.89%。经单因素分析,年龄≥70岁患者的死亡率30.88%高于<70岁患者的3.57%,有脑血管病后遗症患者的死亡率44.00%高于无脑血管病后遗症患者的9.03%,发病时间≥3 d患者的死亡率21.54%高于发病时间<3 d患者的9.57%,入院白蛋白<30 g/L患者的死亡率47.37%高于入院白蛋白≥30 g/L患者的9.94%,年龄≥70岁、有脑血管病后遗症、发病时间≥3 d及入院白蛋白<30 g/L为上消化道穿孔患者死亡的影响因素(P<0.05)。将脑血管病后遗症、年龄、发病时间以及入院白蛋白纳入Logistic回归模型,经分析显示,年龄≥70岁、有脑血管病后遗症及入院白蛋白<30 g/L是上消化道穿孔患者死亡的独立危险因素(P<0.05)。结论上消化道穿孔患者死亡的危险因素为年龄≥70岁、有脑血管病后遗症以及入院白蛋白<30 g/L,值得医疗界引起重视。Objective To analyze the risk factors of death in patients with upper gastrointestinal perforation.Methods The clinical data of 180 patients with upper gastrointestinal perforation were retrospectively analyzed,and their deaths were counted.The influencing factors and risk factors of death in patients with upper gastrointestinal perforation were analyzed by univariate and logistic regression analysis.Results Among 180 patients with upper gastrointestinal perforation,25 cases died,with a mortality rate of 13.89%.Univariate analysis showed that the mortality rate 30.88%of patients aged≥70 years was higher than 3.57%of patients<70 years old,the mortality rate of patients with sequelae of cerebrovascular disease 44.00%was higher than 9.03%of patients without sequelae of cerebrovascular disease,the mortality rate 21.54%of patients with onset time≥3 d was higher than 9.57%of patients with onset time<3 d,and the mortality rate 47.37%of patients with albumin on admission<30 g/L was higher than that 9.94%of patients with albumin on admission≥30 g/L.Age≥70 years old,with sequelae of cerebrovascular disease,onset time≥3 d,and admission albumin<30 g/L were the influencing factors of death of patients with upper gastrointestinal perforation(P<0.05).The sequelae of cerebrovascular disease,age,time of onset,and protein on admission were included in the logistic regression model.Analysis showed that patients aged≥70 years old with sequelae of cerebrovascular disease and albumin on admission<30 g/L were independent risk factors of death of patients with upper gastrointestinal perforation(P<0.05).Conclusion The risk factors of death in patients with upper gastrointestinal perforation are age≥70 years old,with sequelae of cerebrovascular disease and albumin on admission<30 g/L.It is worthy of attention in the medical field.

关 键 词：上消化道穿孔 死亡 危险因素 脑血管病后遗症 年龄 白蛋白 

分 类 号：R656[医药卫生—外科学]