伴发有低血钠的危重病患者的预后及危险致病因素分析

ANALYSIS OF PROGNOSIS AND RISK FACTORS WITH IN CRITICALLY ILL PATIENTS HYPONATREMIA

目的 :确定低血钠对危重病患者病死率的影响及哪些危险因素易导致低血钠的发生。方法 :用 APACHE 评分系统对入院诊断及疾病严重程度不同的患者进行合理分层 ,并在患者基础疾病严重程度和年龄基本一致的情况下配对比较和分析有低血钠患者和无低血钠患者的病死率。同时用单因素 χ2 检验和多因素 L ogistic回归分析筛选和判定低血钠发生的危险因素。结果 :低血钠在危重患者中有较高的发生率 (16 .83% )。在条件基本一致的情况下 ,低血钠患者比血钠正常患者有更高的病死率。监护病室低血钠的发生主要与患者患有肾功能衰竭 ,肝功能衰竭或肝硬化 ,白蛋白较低 ,短期内液体正平衡较多 ,基础疾病较严重及患者发生感染等因素有关。结论 :低血钠是监护病室常见并发症且对疾病转归有不利影响 ,应重视并针对其相应危险因素加以预防。

Objective:To assess the effect of hyponatremia on the mortality of critically ill patients and to determine some risk factors which are obviously associated with hyponatremia Methods:The patients with different diagnosis and different severity of underlying disease were classified by APACHEⅡscore and then the mortality of patients with hyponatremia were compared with that of control patients with out hyponatremia They were compared on basically the same underlying disease and age The potential risk factors associated with hyponatremia were selected by univariate analysis and logistic regression analysis Results:The incidence of hyponatremia for patients in ICU is high(16 8 percent) The observed mortality of the patients with hyponatremia is higher than that of patients without hyponatremia under the basically same situation In univariate analysis and logistic regression analysis,the main risk factors for hyponatremia are renal insufficiency, liver insufficiency or cirrhosis,low concentration of albumin,water retention, severe underlying disease and sepsis Conclusion:The effect of hyponatremia on the outcome of critically ill patients is harmful To reduce the incidence of hyponatremia, we should pay more attention to the patients in high risk for developing hyponatremia