影响脓毒血症输血患者预后的危险因素分析

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目的 探讨影响脓毒血症输血患者预后的危险因素,为脓毒血症患者提供安全、科学的输血建议.方法 通过回顾性分析收集本院2018年1月~2021年6月的134名脓毒血症患者临床资料,按照输血与否分为输血组(n=45)与未输血组(n=89),比较2组患者的临床基本资料及实验室指标;按照生存结局和是否发生脓毒症休克将输血组患者再分成死亡组(n=17)与未死亡组(n=28)、休克组(n=12)与未休克组(n=33);使用Logistic回归分析了解影响脓毒血症患者输血后生存结局及发生脓毒症休克的危险因素.结果 输血组和未输血组患者在Hb(71.4±15.7 vs 100.6±21.9)g/L、PCT(13.7±27.2 vs 6.7±18.1)ng/mL、CRP(80.4±81.9 vs 46.6±67.1)mg/mL、APTT(43.4±22.6 vs 33.3±12.8)s、Fib(3.0±1.7vs4.0±1.7)g/L、LAC(3.4±4.2 vs 1.9±2.7)mmol/L、住院天数(20.6±18.7 vs 14.1±10.9)d、及生存结局上均有差异(P<0.05);多因素Logistic回归分析红细胞储存天数(OR=0.183)及患者Hb水平(OR=0.034)均是影响脓毒血症患者输血后生存结局的危险因素(P<0.05).结论 脓毒血症患者输血组与未输血组相比,输血组患者住院天数更长,且在生存结局上存在差异;红细胞储存天数及患者Hb 水平是影响脓毒血症患者输血后生存结局的危险因素,对于脓毒血症患者而言,应选择储存时间短的红细胞进行输注.
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