摘要
目的探讨不同程度高钠血症与颅脑损伤患者死亡的相关风险.方法将近5年ICU的颅脑损伤患者431例根据血钠水平分为4组,非高钠组(〈150mmol/L)、轻度高钠组(150~155mmol/L)、中度高钠组(155~160 mmol/L)、重度高钠组(≥160mmol/L),分析血钠水平与患者死亡的相关风险.结果重度高钠组患者的Glasgow昏迷评分(GCS)3.27±0.89,APACHE-II评分35.25±6.01,病死率93.82%,与轻、中度高钠组患者相比,具有统计学差异(P〈0.05).Logistic多因素分析提示GCS评分下降(OR=3.96,95%CI=1.43~10.96,P〈0.05),APACHE-II评分升高(OR=1.32,95%CI=1.21~1.41,P〈0.05)和重度高钠血症(OR=6.07,95%CI=3.19~13.87,P〈0.05)是颅脑损伤患者的死亡危险因素.结论重度高钠血症是脑外伤患者死亡的主要危险因素之一.
Objective To investigate the relationship between hypernatremia and the mortality risk for patients with trau-matic brain injury (TBI). Methods Fours hundred and thirty one patients with TBI were enrolled in the study. Based on blood serum sodium level patients were divided into four groups:noon-hypernatremia (serum sodium〈150mmol/L), mild hypernatrem-ia (serum sodium:150~155mmol/L), moderate hypernatremia (serum sodium: 155~160mmol/L) and severe hypernatremia (serum sodium≥160mmol/L). The risk of mortality with the serum sodium levels was analyzed. Results Severe hypernatremia groups had the lowest Glasgow Coma Scale (3.27±0.89) and the highest APACHE-II Scale (35.25±6.01) with a mortality rate of 93.82%. Logistic regression multivariable analysis showed that the decreased Glasgow Coma Scale (OR=3.96, 95%CI=1.43~10.96, P〈0.05), increased APACHE-II Scale (OR=1.32, 95%CI=1.2~1.41, P〈0.05) and severe hypernatremia (OR=6.07, 95%CI=3.19~13.87, P〈0.05) were major risk factors for mortality of TBI patients. Conclusion Severe hypernatremia is a major risk factor for mortality of patients with traumatic brain injury.
出处
《浙江医学》
CAS
2013年第7期550-552,共3页
Zhejiang Medical Journal
关键词
高钠血症
颅脑损伤
死亡危险因素
Hypernatremia Traumatic brain injury Risk factors for mortality