创伤合并急性肺损伤患者死亡危险因素早期评估

Early Assessment of Mortal Factors of Patients of Trauma with Acute Lung Injury

目的探讨创伤合并急性肺损伤(ALI)患者死亡危险因素的早期评估指标。方法将创伤合并ALI患者115例按预后分为死亡组(27例)和存活组(88例),对影响患者死亡的相关因素进行Logistic回归分析。结果两组患者入院24 h内血pH值、血肌酐、血清清蛋白(ALB)水平及急性生理与慢性健康状况Ⅱ评分(APACHEⅡ评分)、损伤严重度评分(ISS评分)、格拉斯哥昏迷量表(GCS)评分比较,差异均有统计学意义(P<0.01);而血白细胞计数(WBC)比较,差异无统计学意义(P>0.05)。Logistic回归分析显示,进入回归模型的因素是WBC、血肌酐、ALB,其OR值分别为7.704、14.482和3.353。结论 WBC、ALB、血肌酐均能够早期预测创伤合并ALI的患者死亡,WBC≥13×109/L、血肌酐≥110 mmmol/L、ALB≤30 g/L均能够增加创伤合并ALI患者死亡,有这些危险因素的患者应早期治疗以防止病情进一步恶化。

Objective To analyze the risk factors in order to predict in-hospital mortality of patients with the trauma with acute lung injury.Methods 115 patients of trauma with acute lung injury were divided into mortal group（27 patients） and live group（88 patients）.Mortality factors were analyzed by the logistic analysis.Results The difference in pH,creatinine,ALB,acute physiology,health evaluation Ⅱ（APACHEⅡ score）,injury severity score（ISS score）,Glasgow coma scale（GCS score） of patients within 24 hours was significant（P0.01）;but the WBC showed no statistical difference（P0.05）.The logistic analysis showed that logistic model factors were WBC of count,creatinine,albumin,and their OR were 7.704,14.482,3.353 respectively.Conclusion The ALB,WBC,Creatinine can be used for early predicting the mortality of the trauma with acute lung injury patients.WBC≥13×109/L,Creatinine≥110 mmol/L and ALB≤30 g/L can increase the mortality of the trauma with acute lung injury.Patients with these risk factors need aggressive supportive care as early as possible in order to prevent further aggravation.