330例危重病患者临床特点分析

Analysis on the Clinical Characteristics of 330 Patients with Severe Emergency Diseases

目的:探讨危重病患者临床特点,分析其预后因素.方法:回顾性收集总结在我院急诊ICU住院的资料完整的危重症患者330例,分析其临床特点、诊治主要指标、预后情况及其影响因素.结果:(1)330例患者中,死亡组(N=108)比存活组(N=222),昏迷者较多及程度较重,白蛋白减低,C反应蛋白(CRP)升高,APACHEⅡ评分高(P<0.002～0.0001).(2)死亡组比存活组多系统功能损害发生率高.(3)老年患者比非老年人白蛋白及血红蛋白(Hb)减低,高血压、感染及多系统损害出现率高.(4)主要死亡病因包括:脑梗死、多系统功能损害、休克、心力衰竭及脑出血等.(5)多元回归分析显示,APACHEⅡ评分与预后不良呈正比.结论:危急重症患者要重视多项预后评估,危险分层,以指导临床救治.

Objective：Toinvestigate the clinical Characteristics of severe emergency diseases and its prognosis. Method： Three hundreds and thirty patients with severe emergency diseases were included and whose Clinical Characteristics and prognosis factors were analyzed retrospectively.Results： （1） In 330 cases, compared with survival group （n = 222）, there were higher pravelenee rates of coma, c - reactive protein（CRP） and APACHE Ⅱ＇s score increased, as well as plasma albumin decreased in death group （n = 108） （P 〈 0. 002 ～0. 001 ）. （2） There were more cases of multi - organ dysfunction syndrome （MODS） in death group than survival. （3） Compared with non - elderly cases, there were higher pravelence rates of hypertension, infection and MODS, as well as albumin and hemoglobin decrease in death group. （4） Main dead causes included as following： cerebral infarction, MODS, Shook, heart failure and cerebral hemorrhage etc. （5） By using of multi - variate regression analysis, it was showed that Apache Ⅱ score correlated to prognosis positively and had certain predictive vatue. Conclusion： It should pay more attention to prognosis assessment, risk stratification and management effectively in cases of severe emergency diseases.