外科脓毒血症病人血磷水平变化的初步研究  

Hypophosphatemia in Patients with SIRS,Sepsis or Septic Shock

作　　者：刘伟[1] 汤耀卿[1] 毛恩强[1] 秦帅[1] 闵东[1] 瞿洪平[1] 

机构地区：[1]上海第二医科大学附属瑞金医院外科ICU,200025

出　　处：《外科理论与实践》2003年第5期400-402,共3页Journal of Surgery Concepts & Practice

摘　　要：目的:研究外科危重病人在全身炎症反应综合征(SIRS)、脓毒血症和脓毒性休克阶段血磷水平变化的趋势。方法:回顾性研究2003年1月到2003年4月在瑞金医院外科ICU连续入住病人的血磷值,比较不同病程阶段(非重症、SIRS、脓毒血症和脓毒性休克)病人的血磷水平。结果:在外科ICU非重症病人中,血磷水平都正常;而在SIRS阶段病人,部分标本的血磷水平降低(占标本数30.4%),但平均值仍属正常。脓毒血症阶段病人的血磷水平则明显降低,平均为(0.66±0.17)mmol/L,显示低磷血症的标本数占90.9%;脓毒性休克时病人的血磷降低更为明显,平均为(0.48±0.22)mmol/L。方差分析显示各组间两两比较都有显著差异。结论:外科危重病人中,随着疾病从SIRS加重到脓毒性休克,其血磷降低程度亦逐渐加重。Objective:To determine the trend of hypophosphataemia in patients with SIRS,sepsis or septic shock.Methods:Plasma phosphate level of patients consecutively admitted into SICU of Ruijin hospital during Jan2003-Apr2003were analyzed retrospectively.Acording to the severity of general conditions(mild infection,SIRS,sepsis or septic shock),the patients were divided into4groups.The ANOVA procedure was performed for comparison.Results:In the mild group,no hypophosphatemia was found,while in the SIRS group,30.4%of the cases showed hypophosphataemia,even although the mean level of remained normal;in the sepsis group,plasma phosphate level decreaed significantly,the mean level was(0.66±0.17)mmol/L,one of the patient cases demonstrated severe hypophosphataemia(<0.32mmol/L);in the septic shock group,all except one showed hypophosphataemia,and four developed severe hypophosphataemia.Comparison between showed all the pairs significant difference.Conclusions:In patients with SIRS,sepsis and septic shock of SICU,the hy-pophosphataemia decreased gradually while the disease deteriorated.

关 键 词：脓毒血症 血磷 全身炎症反应综合征 脓毒性休克 低磷血症 

分 类 号：R631[医药卫生—外科学]