孕产妇失血性休克肺损伤的影响因素

Factors Involved in Lung Injury of Hemorrhagic Shock in Pregnant or Lying-in Women

目的 :探讨孕产妇失血性休克肺损伤的影响因素。方法 :对 18例因失血性休克而死亡的孕产妇的肺组织进行肺损伤程度 (Y)评分 ,并计数肺微血管床的白细胞滞留数 (X1 )。采用多元线性回归和相关方法 (逐步回归法 )分析X1 、出血持续时间 (X2 )、孕期 (X3)、是否输注高渗盐溶液 (X4 )、出血量 (X5)及患者年龄 (X6 )对 Y的影响。结果 :Y与 X1 、X2呈正相关 (相关系数为 0 .86 4和 0 .85 6 ) ,Y与 X3、X4 呈负相关 (相关系数为 - 0 .912和 - 0 .75 2 ) ;建立最优回归方程 Y=5 .839+0 .0 0 8173X1 +0 .0 35 2 8X2 - 0 .0 1393X3,方程经方差分析 F等于 6 9.4 90 ,P=0 .0 0 0 <0 .0 5 ,各变量回归系数经 t检验 ,P值均小于 0 .0 5。变量 X4 、X5、X6 被剔除。结论 :白细胞在孕产妇失血性休克肺损伤中发挥重要作用 ,出血持续时间越长 ,孕期越短 ,肺损伤越重。输注高渗盐溶液可减轻肺损伤 ,但其重要性较低。

Objective:To study factors involved in lung injury of hemorrhagic shock in pregnant or lying-in women.Methods:Lung injury degree(Y) of 18 cases of hemorrhagic shock in pregnant or lying-in women was estimated and leucocyte retention(X 1)of tiny vein in lung tissue was counted.A linear regression analysis was performed to evaluate the effects of X 1, hemorrhagic duration(X 2), pregnant duration(X 3), application of hypertonic saline(X 4), hemorrhage volume(X 5) and ages(X 6) on lung injury.Results:Positive correlation was found between Y and X 1 or X 2. There were negative correlations between Y and X 3 or X 4. The regression model was showed as fellowing:Y=5.839+0.008173X 1+ 0.03528X 2-0.01393X 3, The analysis of variance showed that F is 69.490, P=0.000<0.05. The T test of regression coefficient of various variable showed that P is less than 0.05. The variables including X 4 ,X 5 and X 6 were rejected.Conclusion:Leucocyte has an important role in lung injury of hemorrhagic shock in pregnant or lying-in women. Lung injury increased with the extension of hemorrhagic duration and pregnant duration shorten.Infusion of hypertonic saline may alleviate lung injury,but it is not very important.