恶性肿瘤合并脓毒血症患者发生休克危险因素分析  

Risk factors for shock in patients with malignant tumors and sepsis

作　　者：温莎 王帅 杜弈霏 WEN Sha;WANG Shuai;DU Yifei(Department of Critical Care Medicine,Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital,Zhengzhou 450003,Henan Province,China)

机构地区：[1]郑州大学附属肿瘤医院/河南省肿瘤医院重症医学科,河南郑州450003

出　　处：《新乡医学院学报》2025年第5期406-409,共4页Journal of Xinxiang Medical University

摘　　要：目的 探讨恶性肿瘤合并脓毒血症患者发生休克的危险因素。方法 选择2020年9月至2023年9月在郑州大学附属肿瘤医院/河南省肿瘤医院接受治疗的恶性肿瘤合并脓毒血症患者180例为研究对象,根据是否发生休克分为休克组(n=76)和未休克组(n=104)。收集2组患者的性别、年龄、体质量指数(BMI)、原发肿瘤、肿瘤分期、合并感染部位、脏器损伤个数、急性生理学及慢性健康状况评分系统(APACHEⅡ)评分、中性粒细胞计数(ANC)及降钙素原(PCT)、血乳酸(Lac)、C-反应蛋白(CRP)水平等临床资料,应用单因素分析和二元logistic回归分析确定恶性肿瘤合并脓毒血症患者发生休克的影响因素。结果 180例恶性肿瘤合并脓毒血症患者发生休克76例,休克发生率为42.22%。单因素分析结果显示,休克组与未休克组患者合并感染部位、脏器损伤个数、APACHEⅡ评分、ANC及PCT、Lac、CRP水平比较差异有统计学意义(P<0.05);2组患者的性别、年龄、BMI、原发肿瘤、肿瘤分期比较差异无统计学意义(P>0.05)。二元logistic回归分析结果显示,合并肺部感染、脏器损伤>3个、高PCT、高Lac及高CRP水平是恶性肿瘤合并脓毒血症患者发生休克的危险因素(P<0.05)。结论 恶性肿瘤合并脓毒血症患者发生休克风险较高,合并肺部感染、脏器损伤>3个、高PCT、高Lac及高CRP水平是导致恶性肿瘤合并脓毒血症患者发生休克的危险因素。Objective To explore the risk factors for shock in patients with malignant tumors and sepsis.Methods A total of 180 patients with malignant tumors and sepsis treated at Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital from September 2020 to September 2023 were included,who were divided into a shock group(n=76)and a non-shock group(n=104)based on whether shock occurred.The clinical data of patients in the two groups,including gender,age,body mass index(BMI),tumor type,tumor stage,co-infection site,number of injured organs,acute physiology and chronic health evaluation scoring system(APACHEⅡ)score,absolute neutrophil count(ANC),procalcitonin(PCT),lactate(Lac),C-reactive protein(CRP)levels,were collected.The univariate and binary logistic regression analysis were used to investigate the influencing factors of shock in patients with malignant tumors and sepsis.Results There were 76 cases of shock among the 180 patients with malignant tumors and sepsis,with the incidence of shock being 42.22%.The univariate analysis showed that the co-infection site,number of injured organs,APACHEⅡscore,ANC,PCT,Lac,and CRP levels were statistically significantly different between the shock group and non-shock group(P<0.05).However,there was no statistically significant difference in gender,age,BMI,tumor type and tumor stage between these two groups(P>0.05).The binary logistic regression analysis showed that combined lung infections,injured organs>3,high PCT,Lac and CRP levels were risk factors of shock in patients with malignant tumors and sepsis(P<0.05).Conclusion Patients with malignant tumors and sepsis are at high risk of shock.Combined lung infections,injured organs>3,high PCT,Lac and CRP levels are risk factors of shock in patients malignant tumors and sepsis.

关 键 词：恶性肿瘤 脓毒血症 休克 危险因素 

分 类 号：R459.7[医药卫生—急诊医学]