影响危重病患者预后的相关因素分析(1)
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[摘要] 目的 探讨影响危重病患者预后的相关因素。 方法 回顾性分析2010年1月～2011年8月98例我院ICU治疗的危重病患者的临床资料。 结果 98例危重病患者死亡36例，死亡率为36.73%。影响患者预后的相关因素较多，住院时间、MAP、pH值、Ca2+水平、APACHE-II评分、ALT、CRP、Cr、BUN、乳酸、CO2分压、H2S水平、平均动脉压、心率、术中并发症发生率、有创诊疗项目及机械通气时间等均为可能的影响因素(P < 0.05)。多因素回归分析结果显示，住院时间、乳酸、APACHE-II评分、Ca2+水平、有创诊疗项目以及机械通气时间是影响预后的独立因素(P < 0.05)，其中住院时间的保护性因素，其余是死亡危险因素。 结论 影响危重病患者预后的因素众多，可将住院时间、乳酸、APACHE-II评分、Ca2+水平、有创诊疗项目以及机械通气时间作为评估患者预后的重要指标，根据多种指标的结果及患者病情采取积极的抢救措施，以降低患者病死率。
[关键词] 危重病；预后；因素
[中图分类号] R459.7 [文献标识码] B [文章编号] 1673-9701(2012)03-0064-02
Study on the relatively risk factors influenced the prognosis for critically-ill patients
PENG Zhiguo
Department of Emergency, Jinhua City Central Hospital in Zhejiang Province, Jinhua 321000, China
[Abstract] Objective To investigate relatively risk factors influenced the prognosis for critically-ill patients. Methods The clinical data of 98 critically-ill patients were analyzed. Results Themortality rate was 36.73%. There were many relatively risk factors may influence the prognosis for critically-ill patients, such as ICU stay, mean arterial pressure, acute physiology and chronic health evaluation (APACHE-II), PH value, carbon dioxide partial pressure, Ca2+, alanine aminotransferase, aspartate aminotrasferse, lactate, C-reactive protein, creatine, uric acid nitrogen, hydrogen sulfide, hypocalcemia incidence, invasive treatment and time of mechanical ventilation (P < 0.05). The logistic regression analysis showed that ICU stay, APACHE-II, Ca2+, lactic acid, invasive treatment and the time of mechanical ventilation were independent factors influencing prognoses of critically-ill patients. Conclusion There are many relatively risk factors may influence the Prognosis for critically-ill patients, ICU stay, APACHE-II, Ca2+, lactic acid, invasive treatment and the time of mechanical ventilation could be used as reference indexes for critically-ill patients, we should take an active rescue measures according to the results of a variety of indicators and the patient's condition, in order to reduce mortality rate of critically-ill patients ......
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