晚期肺癌并发多器官功能障碍综合征患者急救预后的影响因素

Analysis of influential factors of first aid prognosis in patients with advanced lung cancer complicated with multiple organ dysfunction syndrome

目的:探讨晚期肺癌并发多器官功能障碍综合征(MODS)患者急救预后的影响因素。方法:选取我院于2014年1月至2017年1月期间收治的晚期肺癌并发MODS患者96例,按照患者入院28 d预后情况分为生存组(n=37)与死亡组(n=59例)。均于入院后采用综合治疗,且调查患者一般资料包括性别、年龄、APACHE II评分、MODS评分、器官衰竭数目、C反应蛋白(CRP)、氧合指数、乳酸、血小板、白细胞计数、慢性病史。结果:单因素分析,两组性别、慢性病史比较无统计学差异(P>0.05);而两组器官衰竭数目比较具有统计学差异(P<0.05)。单因素分析,两组APACHE II评分、MODS评分、CRP、乳酸及血小板计数比较具有统计学差异(P<0.05),且生存组APACHE II评分、MODS评分、CRP、乳酸及血小板计数均低于死亡组,具有统计学差异(P<0.05);而两组氧合指数和白细胞计数比较无统计学差异(P>0.05)。将上述单因素分析具有统计学差异的纳入多因素分析,器官衰竭数目、APACHE II评分、MODS评分和乳酸为影响预后的独立危险因素。结论:晚期肺癌并发MODS患者急救预后的影响因素中,器官衰竭数目、APACHE II评分、MODS评分和乳酸为其独立危险因素。

Objective： To investigate the influencing factors of first aid prognosis in patients with advanced lung cancer complicated with multiple organ dysfunction syndrome（ MODS）. Methods： 96 patients with advanced lung cancer complicated with MODS were enrolled in our hospital from January 2014 to January 2017,and were divided into survival group（ n = 37） and death group（ n = 59）. All patients underwent comprehensive treatment. General information included gender,age,APACHE II score,MODS score,number of organ failure,C-reactive protein（ CRP）,oxygenation index,platelet,Lac,white blood cell count,chronic history. Results： There was no significant difference in gender and chronic history between the two groups（ P＜0. 05）. There was significant difference in the number of organ failure between the two groups（ P＜0. 05）. The APACHE II score,MODS score,CRP,platelet and Lac in the survival group were lower than those in the death group（ P＜0. 05）. The APACHE II score,MODS score,CRP,platelet and Lac were statistically different（ P＜0. 05）. There was no significant difference in the oxygenation index and white blood cell count between the two groups（ P＜0. 05）. The above univariate analysis was statistically different from the included multivariate analysis,the number of organ failure,the APACHE II score,the MODS score and Lac were independent prognostic factors for prognosis. Conclusion： The number of organ failure,APACHE II score,MODS score and Lac were the independent risk factors in the prognostic factors of first aid prognosis in patients with advanced lung cancer.