576例伴有急性腹腔内高压患者临床预后及影响因素

The clinical prognosis and influencing factors of 576 patients with acute intraabdominal hypertension

目的 探究急诊患者伴有急性腹腔内高压患者临床预后情况及影响预后的相关因素,为急性腹腔内高压患者的诊治提供科学依据.方法 选择本院2014~2018年收治的急性腹腔内高压患者作为观察对象,观察患者预后情况.采用Logistics回归分析影响患者预后的相关因素.结果 共纳入576例患者,有448例(77.8%)存活,年龄≥60岁、APACHEⅡ≥15分、乳酸≥2mmol/L、CRP≥100mg/L、PCT≥10ng/ml、住院时间≥10d、肺/腹腔感染、慢性阻塞性肺疾病(COPD)、肿瘤、吸烟会增高急性腹腔内高压患者的死亡风险(P<0.05).ROC曲线下面积为0.869(P<0.05),提示模型拟合的效果较好.结论 急诊患者伴有急性腹腔内高压死亡风险较高,而年龄、APACHEⅡ、乳酸、CRP、PCT等是影响其预后的危险因素,临床上予以密切监测和及时干预.

Objective To explore the clinical prognosis of patients with acute intraperitoneal hypertension in emergency department and the related factors that affect the prognosis,so as to provide scientific basis for the diagnosis and treatment of patients with acute intraperitoneal hypertension.Methods The patients with acute intraperitoneal hypertension admitted in our hospital from 2014 to 2018 were selected as the research objects to observe the prognosis of the patients.Logistic regression analysis was used to analyze the factors influencing the prognosis of patients.Results There were 448 patients(77.8%)alive in 576 patients,age ≥60 years old,APACHEⅡ≥15 points,lactate≥2 mmol/L,CRP≥100mg/L,PCT≥10NG/ml,hospital stay≥ 10days,pulmonary/abdominal infection,COPD,tumor,smoking increased the risk of death in patients with acute intraperitoneal hypertension(P<0.05).The area under ROC curve was 0.869(P<0.05),indicated that the model fitting effect was better.Conclusion The risk of death of patients with acute intraperitoneal hypertension in emergency department is high,and age,APACHE Ⅱ,lactate,CRP,PCT are the risk factors that affect their prognosis,so they should be monitored and intervened in time.