感染性休克预后的影响因素分析

Analysis of influencing factors associated with the outcome of septic shock

目的:探讨与感染性休克死亡相关的常用临床指标。方法:将接受标准化治疗的118例感染性休克的成年患者按60 d内的存活情况分为死亡组和存活组,分别统计分析两组的临床指标,包括血压、心率、中心静脉压、慢性健康状况评分Ⅱ(acute physiology and chronic health evaluation scoring system,APACHEⅡ)、严重感染相关器官功能衰竭评分(sepsis-related organ failure assessment,SOFA)以及血乳酸、24 h血乳酸清除率等指标。结果:两组在年龄、收治时血乳酸水平、血小板水平、SOFA评分以及治疗后1 h的血压水平、24 h的血乳酸清除率等指标上差异具有统计学意义。结论:高龄、高乳酸血症、低血小板症、高SOFA分值、治疗后1 h仍存在的低血压值、低的24 h血乳酸清除率均与感染性休克患者的不良预后相关。。

Objective： To explore the common influencing factors associated with the outcome of septic shock. Methodes：118 septic shock patients who have a standardized treatment protocol of early goal directed therapy were divided into two groups（the death group and the survival group）by their survival situation in 60 days, recorded the clinical parameters of the patients, including blood pressure（BP）, heart rate（HR）, central venous pressure（CVP）, acute physiology and chronic health evaluation scoring system（APACHE Ⅱ） score, SOFA（sepsis-related organ failure assessment） score, lactate and clearance rate of lactate in 24 h, all data were analyzed by statistical method. Results： There were remarkable statistical difference between the death group and the survival group in age, basal lactate, basal platelet count, SOFA score, the BP level at one hour after treatment and the clearance rate of lactate in 24 h. Conclusion： Advanced age, hyperlactacidemia, thrombocytopenia, high SOFA score, persistent low BP after the treatment of an hour and low clearance rate of lactate in 24 h were related to the poor prognosis of septic shock.