严重多发伤患者发生应激性溃疡的影响因素分析  

Analysis of factors influencing the occurrence of stress ulcers in patients with severe multiple trauma

作　　者：蒋兰婷 陈莉[1] 姚诗晴 刘彦伶 雷雯 JIANG Lanting;CHEN li;YAO Shiqing;LIU Yanling;LEI Wen(Affiliated Nanhua Hospital of University of South China,Hengyang 421002,China;School of Nursing of University of South China,Hengyang 421001,China)

机构地区：[1]南华大学附属南华医院护理部,湖南省衡阳市421002 [2]南华大学护理学院,湖南省衡阳市421001

出　　处：《护理实践与研究》2024年第11期1650-1656,共7页Nursing Practice and Research

基　　金：湖南省卫生健康委科研课题(编号:202214024890)。

摘　　要：目的回顾性调查分析严重多发伤患者发生应激性溃疡的影响因素,以期尽早识别高风险患者,为早期预防严重多发伤患者应激性溃疡的发生提供参考。方法选取2021年1月—2023年1月湖南省某三级甲等综合医院重症监护室的494例严重多发伤患者作为调查对象,回顾性收集相关资料。按住院期间有无发生应激性溃疡分为应激性溃疡组(n=132)和非应激性溃疡组(n=362)。对两组资料进行单因素分析,对单因素分析结果有统计学意义的变量进行多因素分析,分析严重多发伤患者发生应激性溃疡的影响因素。结果多因素分析发现急性生理及慢性健康状况(APACHEⅡ)评分、格拉斯哥昏迷(GCS)评分、镇痛镇静药物使用天数、留置胃管或鼻肠管天数、乳酸、肠内营养天数是严重多发伤患者发生应激性溃疡的独立影响因素(P<0.05)。结论严重多发伤后患者出现应激性溃疡的可能性较高,且应激性溃疡的发生与APACHEⅡ评分、GCS评分、镇痛镇静药物使用天数、留置胃管或鼻肠管天数、肠内营养天数、乳酸等直接相关,动态评估这些影响因素能及时预警应激性溃疡的发生,为后期的治疗和护理提供参考和依据。临床医护人员可以积极干预可能导致严重并发症的影响因素,降低应激性溃疡发生率。Objective To retrospectively investigate and analyze the factors influencing the occurrence of stress ulcers in patients with severe multiple trauma,with the aim of identifying high-risk patients as early as possible and providing a reference for the early prevention of stress ulcers in these patients.Methods A total of 494 patients with severe multiple trauma,admitted to the intensive care unit of a tertiary grade A general hospital in Hunan Province from January 2021 to January 2023,were selected as the survey subjects.Relevant data were retrospectively collected.The patients were divided into two groups based on the occurrence of stress ulcers during hospitalization:the stress ulcer group(n=132)and the non-stress ulcer group(n=362).The data for two groups were analyzed using univariate analysis,and the variables with statistically significanct results from the univariate analysis were analyzed using multivariate analysis to identify the factors influencing the occurrence of stress ulcers in patients with severe multiple trauma.Results Multivariate analysis showed that the Acute Physiology and Chronic Health Evaluation(APACHE-Ⅱ)scores,Glasgow Coma Scale(GCS)scores,the number of days of using analgesic and sedative medications,the number of days of indwelling gastric tube or nasoenteric tube,lactate levels,and the number of days of enteral nutrition were independent factors influencing the occurrence of stress ulcers in patients with severe multiple trauma(P<0.05).Conclusion Patients with severe multiple injuries are more likely to develop stress ulcers.The occurrence of stress ulcers is directly related to factors such as APACHE Ⅱ score,GCS score,number of days of using analgesic and sedative medications,the number of days of indwelling gastric tube or nasoenteric tube,the number of days of enteral nutrition,and lactate levels.Dynamic assessment of these influencing factors can provide timely warnings for the occurrence of stress ulcers,offering references and basis for later treatment and care.Clinical med

关 键 词：严重多发伤 应激性溃疡 影响因素 LOGISTIC回归分析 回顾性研究 

分 类 号：R473.6[医药卫生—护理学]