脓毒症患者胃肠道功能不全综合征的临床特征分析

Clinical characteristics of sepsis patients with gastrointestinal dysfunction syndrome

目的探讨脓毒症患者发生胃肠道功能不全综合征（GIDS）的临床特征和影响因素及对临床预后的影响，为临床诊治提供参考。方法回顾性分析2011年10月-2012年10月北京市海淀医院ICU收治的110例脓毒症患者的临床资料，根据ICU期间GIDS发生与否，将入选患者分为GIDS组和非GIDS组，应用单因素分析比较两组间各因素的差异，从而得到影响GIDS的危险因素。结果共有72例脓毒症患者发生GIDS,发生率为65. 5% ;59. 8%的GIDS发生在人住ICU 7-14 d；GIDS的ICU病死率为47. 2% ,非GIDS为21. 1%，两者差异有统计学意义（P〈0.01）;GIDS住ICU时间为（18. 6±13. 6）d,非GIDS为（14. 2±7. 8）d，两者差异有统计学意义（P〈0. 05）;髙龄、腹腔感染、高SOFA评分以及早期应用儿茶酚胺类药物是脓毒症患者发生GIDS的危险因素。结论GIDS是脓毒症常见的并发症，能明显影响脓毒症的预后。

OBJECTIVE To study clinical characteristics, risk factors and clinical prognosis of the sepsis patientswith gastrointestinal dysfunction syndrome （GIDS） so as to guide the clinical diagnosis and treatment. METHODSA retrospective analysis of the clinical data of 110 sepsis patients who were admitted to ICU in Peking HaidianHospital was performed between Oct 2001 and Oct 2002. GIDS was defined as documented gastrointestinal prob-lems （food intolerance, gastrointestinal haemorrhage, and/or ileus） in the patient data at any period of their ICUstay, then the enrolled patients were divided into the GIDS group and the non-GIDS group according the status ofincidence of GIDS during the ICU stay,the univariate analysis was performed to compare the factors between thetwo groups so as to determine the risk factors for the GIDS. RESULTS GIDS was identified in 72 cases of sepsispatients with the incidence rate of 65. 5 %,59. 8% of the GIDS patients were identified at 7-14 days after the ad-mission to ICU; the mortality was 47. 2% in the GIDS group, 21. 1 % in the non-GIDS group, the difference between two groups was significant; the length of ICU stay was （18. 6± 13. 6）d in the GIDS group, （14. 2±7. 8）din the non-GIDS group, the difference between the two groups was significant（P〈0. 05）. The advanced age, ab-dominal cavity infection, high SOFA score, and use of catecholamines in early stage were the risk factors for the GIDS in the sepsis patients. CONCLUSION GIDS is a common complication of the sepsis patients, which can sig-nificantly influence the prognosis of sepsis.