腹腔感染相关脓毒症患者凝血功能障碍发病及危险因素分析  

Risk factors analysis of sepsis induced coagulopathy caused by intra-abdominal infection

作　　者：郭晓芳[1] 梁培[2] 尤勇[1] 朱章华[1] GUO Xiaofang;LIANG Pei;YOU Yong;ZHU Zhanghua(Department of Critical Care Medicine,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing,210008,China;Department of Pharmacy, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School)

机构地区：[1]南京大学医学院附属鼓楼医院重症医学科,南京210008 [2]南京大学医学院附属鼓楼医院药学部

出　　处：《临床急诊杂志》2022年第4期260-264,共5页Journal of Clinical Emergency

摘　　要：目的:探讨腹腔感染相关脓毒症凝血功能障碍的危险因素。方法:回顾性研究我院ICU2018年7月—2019年12月期间收治的145例腹腔感染相关脓毒症患者的临床资料,根据脓毒症凝血功能障碍诊断标准分为凝血障碍组和凝血正常组,进行单因素和多因素logistic回归性分析。结果:腹腔感染相关脓毒症患者凝血功能障碍发病率为42.76%,病死率22.58%。凝血正常组和凝血障碍组APACHEⅡ评分、发病至入院时间、手术时间、休克、血浆乳酸及降钙素原比较,均差异有统计学意义(均P<0.05);logistic多因素回归分析显示:乳酸(OR=1.462,P<0.05)、降钙素原(OR=1.043,P<0.05)与腹腔感染相关脓毒症发生凝血功能障碍相关。与凝血正常组比较,腹腔感染相关脓毒症凝血障碍组ICU住院时间、多器官功能衰竭及30 d病死率比较差异有统计学意义(P>0.05)。结论:凝血功能障碍是腹腔感染相关脓毒症常见的并发症之一,病死率高,并发症多,血浆乳酸、降钙素原是腹腔感染相关脓毒症患者发生凝血功能障碍的危险因素。Objective:To analyze the risk factors Analysis of sepsis induced coagulopathy caused by intra-abdominal infection.Methods:A total of 145 adult patients with sepsis caused by intra-abdominal infection admitted to the Department of Intensive Care Unit of Nanjing Drum Tower Hospital from July 2018 to December 2019 were included in the study.According to sepsis-induced coagulopathy scoring criteria,the patients were assigned into an coagulopathy group and non-coagulopathy group.Comparing the differences in clinical data of two groups with univariateanalysis and logistic analysis were used to identify the risk factors of coagulopathy.Results:The overall incidence of coagulopathy was 42.76%,and the mortality was 22.58%.Univariateanalysis revealed that there were significant differences in APACHE Ⅱ score、Time from ache to initiation of being admitted to hospital、Duration of surgery、shock and lactate and procalcitonin(all P<0.05).Lactate(OR=1.462,P<0.05) and procalcitonin(OR=1.043,P<0.05) were found to be related to the development of coagulopathy by logistic analysis.Conclusion:Sepsis-induced coagulopathy is a common complication in patients with intra-abdominal infection and has a high mortality.This study shows that lactate and procalcitonin are risk factors most likely associated with coagulophy development.

关 键 词：腹腔感染 脓毒症 凝血功能障碍 危险因素 

分 类 号：R459.7[医药卫生—急诊医学]