急诊重症肺炎并感染性休克死亡的影响因素分析

Analysis of the Influencing Factors of Severe Pneumonia Complicated with Septic Shock in Emergency Department

目的 研究急诊重症肺炎合并感染性休克患者死亡的主要因素,以便为临床的干预工作提供科学的参考依据。方法 将2020年3月至2021年12月到我院进行治疗的143例急诊重症肺炎合并感染性休克患者作为本文的研究对象,对所有患者的临床资料开展回顾性分析,统计经过治疗无效死亡的病例数和所占比,并分析急诊重症肺炎合并感染性休克死亡的影响因素。结果 (1) 143例急诊重症肺炎合并感染性休克的患者中死亡48例,所占比为33.96%。(2)两组在年龄、肺叶受累数量、器官受累数量、合并慢阻肺、营养状况不良、合并消化道出血、有机械通气、血清白蛋白水平、预防性应用抗生素、抗感染治疗时间、侵入性操作、合并消化道出血、合并肝性脑病、住院时间方面比较差异有显著性(P <0.05),而两组性别无显著性差异(P> 0.05)。(3)年龄超过60周岁、肺叶受累数量达3个以上、器官受累数量超过3个、合并慢阻肺、营养状况不良、合并消化道出血是急诊重症肺炎合并感染性休克患者死亡的独立危险因素(P <0.05)。结论 临床导致急诊重症肺炎合并感染性休克患者死亡的原因是多方面的,主要包括患者的年龄、肺叶受累的数量、器官受累数量、慢阻肺病史、营养状况、消化道出血等。临床应在对患者进行治疗时加强对患者各种情况的重视和病情的观察,采取针对性的措施对患者实施干预,以保证提升治疗的整体效果。

Objective To study the main factors of death in emergency patients with severe pneumonia complicated with septic shock,in order to provide scientific reference for clinical intervention.Methods A total of 143 emergency patients with severe pneumonia complicated by septic shock who were treated in our hospital from March 2020 to December 2021 were selected as the research objects of this paper.The clinical data of all patients were retrospectively analyzed,and the number of deaths after treatment was invalid.The number and proportion of cases were analyzed,and the influencing factors of death from emergency severe pneumonia complicated with septic shock were analyzed.Results(1) Among the 143emergency patients with severe pneumonia complicated with septic shock,48 died,accounting for 33.96%.(2) Age,number of lobes involved,number of organs involved,combined with COPD,poor nutritional status,combined with digestive tract hemorrhage,mechanical ventilation,serum albumin level,prophylactic antibiotics,anti-infective treatment time,invasive operation,combined gastrointestinal bleeding,combined hepatic encephalopathy,hospitalization time,etc.single factor,the difference met the statistical standard(P<0.05).(3) Over 60 years old,more than 3 lung lobes were involved,more than 3 organs were involved,combined with COPD,poor nutritional status,combined with digestive tract bleeding was an independent risk factor for death in emergency patients with severe pneumonia complicated with septic shock,and the difference met the statistical standard(P<0.05).Conclusion The clinical causes of death in emergency patients with severe pneumonia complicated with septic shock are various,mainly including the age of the patient,the amount of waste fluid involved,the number of organs involved,history of chronic obstructive pulmonary disease,nutritional status,gastrointestinal bleeding and so on.When treating patients,the clinic should strengthen the attention to various conditions of patients and the observation of their conditions,and actively intervene in patients through targeted measures,which can ensure the overall efficiency of treatment.