血清白蛋白水平对老年脓毒血症患者的预后以及临床治疗过程的影响

The Effect of Serum Albumin Levels on the Prognosis and the Clinical Treatment Process of Elderly Septicopyemia Patients

目的探讨血清蛋白血水平在老年脓毒血症患者临床治疗过程及预后的影响和意义。方法回顾性分析239例入住急诊留观的老年脓毒血症患者的病例资料,测定就诊24小时内的血清白蛋白水平并进行以下分析:1根据预后分成死亡组与存活组,统计两组血清白蛋白水平变化;2根据血清白蛋白水平分成正常白蛋白组、轻度低至白血症组、重度低蛋白血症组,对其留观期间抗生素使用的时间和抗生素使用的种类进行统计分析。结果 1存活组血清白蛋白水平明显高于死亡组,差异有统计学意义(P<0.05);2正常白蛋白组、轻度低蛋白血症组和重度低蛋白血症组之间相比,抗生素使用的时间和抗生素使用的种类均存在统计学差异。结论老年脓毒血症患者的血清白蛋白水平与临床治疗过程的难度和病死率均高度相关,临床上应尽可能的采取多种营养支持手段来帮助患者提高血清白蛋白水平以提高这一类患者的治疗成功率,同时减少抗生素使用时间和种类,缩短住院时间,以减轻患者的医疗负担。

Objective Discuss the influence and significance of the serum albumin levels in the clinical treatment and prognosis of elderly septicopyemia patients. Methods Retrospective analysis of 239 cases in the emergency department under observation data of elderly patients with sepsis,to determine the serum albumin level clinic in 24 hours and make the following analysis： 1 According to prognosis into death group and alive group,statistical two groups of serum albumin level changes; 2 According to the serum albumin level divided to the normal albumin group、mild and the severe hypoalbuminemia,antibiotic use during its under observation time and the kinds of antibiotics were analyzed. Results 1 Serum albumin level survival group was obviously higher than that of death group,the difference was statistically significant（ P〈0. 05）; 2 Normal albumin group、mild hypoalbuminemia and severe hypoalbuminemia group compared between antibiotic use time and the types of antibiotic use are significant differences. Conclusion In elderly patients with sepsis the serum albumin level and the difficulty of the clinical treatment process and the case fatality rate are highly correlated,clinical should as far as possible to take a variety of nutritional support to help patients improve the level of serum albumin to improve the treatment of patients with this kind of success rate,reduce antibiotic use time and at the same time,shorten hospitalization time,to reduce the medical burden of patients.