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目的探讨急诊危重病监护室(EICU)脓毒性休克患者临床特点及死亡相关危险因素。方法回顾性调查2003年1月～2009年1月间入住笔者医院急诊科EICU的159例脓毒性休克患者临床资料,总结患者临床特点,采用单因素分析和多因素逐步Logistic回归,分析脓毒性休克死亡相关危险因素。结果 159例脓毒性休克患者中,男性96例(60.4%),女性63例(39.6%),平均年龄57.9±16.3岁,器官功能衰竭数目3.38±1.57个,腹部是最常见感染部位(45.3%),心血管系统疾病(38.4%)是最常见的基础疾病;总病死率53.5%(85/159),男性病死率高于女性(60.4%vs 42.9%,P<0.05);多因素逐步Lo-gistic回归显示:合并器官功能衰竭数目、静脉使用碳酸氢钠是脓毒性休克的死亡独立危险因素,血液净化及住院时间是保护因素。结论脓毒性休克的病死率极高,早期积极抢救,运用血液净化等多种抢救措施,防治器官功能衰竭是降低脓毒性休克病死率的关键。
Objective To investigate the clinical features and mortality-related risk factors of patients with septic shock in emergency critical care unit (EICU). Methods The clinical data of 159 patients with septic shock admitted to the hospital emergency department of EICU from January 2003 to January 2009 were retrospectively reviewed. The clinical features of the patients were summarized. Univariate analysis and multivariate stepwise Logistic regression were used to analyze the septic shock Death related risk factors. Results Among 159 patients with septic shock, 96 (60.4%) were male and 63 (39.6%) were female, with an average age of 57.9 ± 16.3 years and 3.38 ± 1.57 organ failure. The abdomen was the most common site of infection (45.3% ), And cardiovascular diseases (38.4%) were the most common underlying diseases. The overall case fatality rate was 53.5% (85/159). The male mortality rate was higher than that of women (60.4% vs 42.9%, P <0.05) The -gistic regression showed that the number of combined organ failure, intravenous sodium bicarbonate was an independent risk factor for death from septic shock, and blood purification and hospital stay were protective factors. Conclusions The mortality of septic shock is extremely high, and early rescue is active. Using various rescue measures such as blood purification, prevention and treatment of organ failure is the key to reduce the mortality of septic shock.