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目的探讨急腹症合并感染性休克患者死亡的相关因素,指导急腹症合并感染性休克的早期诊断与早期治疗。方法回顾性分析54例急腹症合并感染性休克患者的临床资料,运用Logistic回归分析对患者死亡情况进行单因素以及多因素回归分析。结果以7 d为观察期,54例患者经过治疗后,其中43例抢救成功,11例死亡病例中,5例死于呼吸衰竭,4例死于循环衰竭,2例死于多器官功能衰竭;手术过程中死亡5例,术后第1天死亡3例,术后第3天死亡2例,术后第7天死亡1例。采用Logistic单因素分析发现,年龄、白蛋白水平(首诊)、降钙素原水平(首诊)、器官衰竭个数(个)、是否存在全身炎症反应综合征与患者的死亡情况相关(P<0.05)。运用Logistic回归分析后发现,年龄(≥65岁)、白蛋白水平(<30 g/L)、降钙素原水平(≥0.5 ng/ml)、全身炎症反应综合征、器官衰竭个数(≥2个)为急腹症合并感染性休克患者死亡的独立危险因素。结论临床上,需密切注意急腹症合并感染性休克患者的危险因素,及早进行干预,提高急腹症合并感染性休克的临床治疗效果,降低死亡率。
Objective To investigate the related factors of death in patients with acute abdomen and septic shock, and to guide the early diagnosis and early treatment of acute abdomen with septic shock. Methods A retrospective analysis of 54 cases of acute abdomen with septic shock in patients with clinical data, the use of Logistic regression analysis of the mortality of patients by single factor and multivariate regression analysis. RESULTS: On the 7th day, 54 patients were successfully treated after salvage, 43 of them were successfully salvaged. Among the 11 deaths, 5 died of respiratory failure, 4 died of circulatory failure and 2 died of multiple organ failure. 5 died during the operation, 3 died on the first day after operation, 2 died on the 3rd day after operation and 1 died on the 7th day after operation. Logistic univariate analysis found that age, albumin level (first visit), procalcitonin level (first visit), the number of organ failure (a), the presence of systemic inflammatory response syndrome and the patient’s death (P <0.05). Logistic regression analysis showed that age (≥65 years), albumin level (<30 g / L), procalcitonin level (≥0.5 ng / ml), systemic inflammatory response syndrome, the number of organ failure 2) were independent risk factors for death in acute abdomen with septic shock. Conclusions Clinically, we should pay close attention to the risk factors of patients with acute abdomen complicated by septic shock and to intervene as soon as possible to improve the clinical effect and reduce the mortality of acute abdomen with septic shock.