ICU骨科手术后脓毒症死亡患者的临床特征分析

Clinical Characteristics of Patients Died of Sepsis After ICU Orthopedic Surgery

目的分析ICU骨科手术患者并发脓毒症死亡的临床特征。方法选取2015年7月—2017年7月我院ICU收治的骨科手术的246例患者作为研究对象。根据患者术后是否出现脓毒症,将分为脓毒症组和对照组,两组在性别、年龄等方面对比,差异无统计学意义(P>0.05),具有可比性。根据患者术转归情况,将脓毒症组的患者进一步分为死亡组与存活组。通过查阅患者的临床资料来获取患者的性别、年龄、感染累及部位、APACHEⅡ评分和外周血的CD64指数,建立数据库并进行分析。在资料收集环节采取双人核对的措施确保获取资料的准确性。结果脓毒症组患者的外周血CD64指数、APACHEⅡ评分高于对照组,差异具有统计学意义(P<0.05);死亡组患者的外周血CD64指数、APACHEⅡ评分高于存活组,差异具有统计学意义(P<0.05);死亡组与存活组的脓毒症患者的感染累计部位对比(P>0.05)。结论医生需密切关注ICU骨科手术患者的APACHEⅡ评分和外周血的CD64指数等临床特征,以尽早采取措施进行干预。

Objective To analyze the clinical characteristics of death from sepsis in ICU orthopedic surgery patients. Methods From July 2015 to July 2017, 246 cases of department of orthopedics operation admitted to our hospital in ICU were selected as the research objects. According to whether the patients had sepsis after operation, they were divided into sepsis group and control group. The difference of sex and age between the two groups was not statistically significant （P 〉 0.05）, and it wascomparable. According to the prognosis of patients, sepsis patients were further divided into death group and survival group. The patient＇s sex, age, infected area, APACHE II score, and CD64 index of peripheral blood were obtained by consulting the patient＇s clinical data, and a database was established and analyzed. Double check measures were taken to ensure the accuracy of data acquisition. Results The peripheral blood CD64 index, sepsis group with APACHE Ⅱ score higher than the control group, the diference was statistically signifcant （P 〈 0.05）; death index, peripheral blood CD64 in patients with APACHE Ⅱ score higher than the survival group, the diference was statistically signifcant （P 〈 0.05）; the death group and survival group of patients with sepsis infection site accumulated no statistically signifcant diference （P 〉 0.05）. Conclusion Doctors should pay close attention to the clinical features such as the APACHE II score of the patients in the ICU Department of orthopedics and the CD64 index of peripheral blood in order to intervene as early as possible.