老年人肺部感染合并胃潴留的临床分析

<TITLE>CLINICAL ANALYSIS OF GASTRIC RETENTION IN THE ELDERLY PATIENTS WITH LUNG INFECTION

目的明确老年人肺部感染患者并发胃潴留的相关危险因素,及胃潴留与患者疾病严重度、预后的关系,以利预防和及时处理,减少老年患者的死亡率。方法用Logistic回归分析方法分析83例不同程度肺部感染患者并发胃潴留的相关危险因素,如感染的病情、脑血管意外、尿毒症、代谢性酸中毒、低血钾、低血钙、MODS、机械通气等情况;分析并发MODS患者器官功能不全数与胃潴留存在是否相关;并分析胃潴留患者的预后。结果病情严重(APACHEⅡ评分高者)、尿毒症、代谢性酸中度、低钾血症、脑血管意外、MODS、机械通气等是老年人肺部感染继发胃潴留的危险因素;老年人肺部感染并发MODS患者,脏器功能衰竭的数量与胃潴留的发生成正相关;老年人肺部感染并发胃潴留者预后差,死亡率高。结论提示老年人肺部感染者发生胃潴留与多种因素有关,尤其是并发MODS患者,而且病情越严重,胃潴留发生越多,预后差。

Objective To investigate the gastrie retention in the elderly patients with hang infection, its correlative factors, and the relationship with gastric retention and the degree of severity of the illness, especially in patients with muhiple organ dysfunetion syndrome （MODS）. Methods 1） 83 ehterly patients with various degrees of lung infection were divided into three groups （Groupl： the score of APACHE Ⅱ 〈15, Group2： the score is from15 to 20, Group3： the score〉20 ）. to observe hasie status, such as degree of illness, hrain stroke, acid toxieosis, uraemia, hypokalimia, hypocalcemia, mechanical ventilation, MODS, and the relationship between the score of APACHE Ⅱ （the degree of illness） and these status, and the relationship between MODS, prognosis and gastric retention. Results There were risk factors of gastric retention such as the high score of APACHE Ⅱ ,MODS, brain stroke, acid toxieosis, uraemia, hypokalimia, meehanieal ventilation,especially in intensive infection with MODS, The gastric retention of patients suffering from MODS with lung infection was more than thai in patients without MODS. The prognosis of sueh patients with gastric retention was very poor. Conclusions It is suggested that patients with serious lung infection existed many risk factors of gastric retention, such as brain stroke, acid toxicosis, uraemia, hypokalimia, hypocalcemia, especially with MODS. Gastric retention is correlative with the degree of illness. The prognosis of patients with gastric retention is poor.