特重度烧伤患者预后影响因素的COX回归分析  

COX regression analyze of prognostic factors in patients with extremely severe burn

作　　者：孙海伟[1] 毛自若[1] 周保纯[1] 马丽梅 刘一畅 朱建军[1] Sun Haiwei;Mao Ziruo;Zhou Baochun;Ma Limei;Liu Yichang;Zhu Jianjun(Department of Emergency and Critical Care Medicine,the Second Affiliated Hospital of SoochowUniversity,Suzhou 215000,China)

机构地区：[1]苏州大学附属第二医院急诊与重症医学科,215000

出　　处：《中华急诊医学杂志》2021年第1期89-92,共4页Chinese Journal of Emergency Medicine

基　　金：江苏省卫健委科研项目(H2018038)。

摘　　要：目的分析影响特重度烧伤患者预后的危险因素。方法回顾性纳入苏州市六所医院ICU收治的2014年8月2日江苏省昆山市铝粉尘爆炸事故中的46例特重度烧伤患者,根据预后将患者分成生存组和死亡组。收集两组患者年龄、性别、入ICU时烧伤程度、白细胞、乳酸、48 h乳酸、肌酐、白蛋白、尿量、血钙、入ICU当日急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分和SOFA评分及90 d预后。采用多因素COX回归分析两组患者各指标对预后(死亡情况)的影响。结果生存组与死亡组患者在入院时,白细胞、肌酐、白蛋白、尿量、SOFA评分和入ICU当日APACHEⅡ评分比较差异无统计学意义(P>0.05);而两组间烧伤程度、乳酸、48 h乳酸以及血钙水平差异有统计学意义(P<0.05)。多因素回归分析结果表明年龄、白蛋白与48 h乳酸水平是特重度烧伤患者死亡的独立预测指标(P<0.05)。结论年龄、白蛋白水平、48 h乳酸水平是影响特重度烧伤患者预后的独立危险因素,能够初步评估特重度烧伤患者的预后。Objective To investigate the risk factors affecting the prognosis of patients with extremely severe burns.Methods Totally 46 patients with extremely severe burn in the dust explosion of aluminum powder in Kunshan,Jiangsu province on August 2,2014 were included in this study.The patients were divided into the survival group and death group according to the prognosis of the patients.The patients'age,sex,burn degree,white blood cell,and lactic acid at admission,lactic acid at 48 h,creatinine,albumin,urine volume,blood calcium,acute physiology and chronic health score system II(APACHE II)and SOFA scores,and 90 d mortality were collected.COX regression analysis was used to analyze the possible relationship between the indicators of the two groups and the prognosis.Results There were no significant differences in white blood cell at admission,creatinine,albumin,urine volume,SOFA score,and APACHE II score in the survival group compared with those in the death group(all P>0.05)and burn degree,the levels of lactic acid at admission,lactic acid at 48 h and blood calcium were significantly different(all P<0.05).Multivariate regression analysis showed that age,albumin and lactic acid at 48 h were independent predictors of death in patients with severe burn(P<0.05),and these are independent outcome predictors of patients with severe burns(P<0.05).Conclusions Age,albumin level and lactic acid at 48 h are independent risk factors affecting the prognosis of patients with severe burns.

关 键 词：特重度烧伤 乳酸 白蛋白 年龄 COX回归分析 

分 类 号：R644[医药卫生—外科学]