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目的分析肾综合征出血热患者预后影响因素,并制定预警性干预对策。方法选取某地区某5家医院2013年7月~2015年7月收治的325例肾综合征出血热患者为研究对象,其中死亡51例患者作为病例组,存活274例患者作为对照组,对两组患者临床资料、血常规、生化指标及并发症等进行单因素分析,并对部分危险因素进行多因素Logistic回归分析,根据结果制定相应的预警性干预对策。结果两组患者性别、TBIL比较差异无统计学意义(P>0.05),年龄、职业、WBC、PLT、Scr、AST、PT、K+比较有显著差异(P<0.05);两组患者消化道出血、肾破裂并发症发生率比较差异无统计学意义(P>0.05),继发感染、脑水肿、颅内出血、中毒性脑病、心衰、呼吸窘迫综合征并发症发生率病例组显著高于对照组(P<0.05);肾综合征出血热预后独立危险因素程度由高到低依次为:呼吸窘迫综合征(OR=6.254)、颅内出血(OR=5.543)、中毒性脑病(OR=5.388)、凝血酶原时间(OR=4.395)年龄(3.287)。结论影响肾综合征出血热预后的独立危险因素主要为呼吸窘迫综合征、颅内出血、中毒性脑病及凝血酶原时间,临床应针对性的制定预警性干预对策,改善预后。
Objective To analyze the influencing factors of prognosis in patients with hemorrhagic fever with renal syndrome, and to develop precautionary intervention strategies. Methods A total of 325 patients with hemorrhagic fever with renal syndrome admitted from July 2013 to July 2015 in 5 hospitals of a certain area were selected as the research object. 51 patients died as the case group and 274 patients survived as the control group. The clinical data, blood routine, biochemical indexes and complications of the patients were analyzed by univariate analysis and multivariate logistic regression analysis of some risk factors. According to the results, corresponding precautionary intervention measures were made. Results There was no significant difference in sex and TBIL between the two groups (P> 0.05). There were significant differences in age, occupation, WBC, PLT, Scr, AST, PT and K + , The incidence of complications of renal rupture was no significant difference (P> 0.05), the incidence of secondary infection, cerebral edema, intracranial hemorrhage, toxic encephalopathy, heart failure, respiratory distress syndrome cases were significantly higher than the control group (OR = 6.254), intracranial hemorrhage (OR = 5.543) and toxic encephalopathy (OR = 5.388), respectively. The risk factors of hemorrhagic fever with renal syndrome were as follows: , Prothrombin time (OR = 4.395) years (3.287). Conclusions Independent risk factors affecting the prognosis of hemorrhagic fever with renal syndrome are mainly respiratory distress syndrome, intracranial hemorrhage, toxic encephalopathy and prothrombin time. Precautionary intervention strategies should be formulated in order to improve the prognosis.