多发伤患者并发多器官功能障碍综合征的危险因素分析

摘要

Objective To investigate the risk factors for multiple trauma patients with mutiple organ dyfunction syndrome(MODS),and to provide the references for clinical diagnosis and treatment .Methods A retrospective analysis on the clinical data of 154 multiple trauma patients was conducted .The 154 patients were divided into MODS group (84 cases) and non-MODS group (70 cases) according to the occurrence of MODS .The relevant factors were analyzed . Results The rate of shock being adjusted within 6 hours after admission ,Glasgow coma score ( GCS) score,red blood cell count and platelet count in MODS group were significantly lower than those in non-MODS group(P<0.05).However, patient′s age,injury severity score (ISS) score,APACHEⅢscore,white blood cell count,random blood glucose in MODS group were significantly higher than those in non-MODS group ( P<0 .05 ) .The non-conditional multivariate logistic regression analysis showed that shock without being adjusted within 6 hours after admission , high ISS score , high APACHEⅢscore were independent risk factors for patients complicated with MODS (P <0.05).The mortality of MODS group was 55.95%,which was higher than that(14.29%) in non-MODS group(P<0.05).The mortality and incidence of MODS showed a positive correlation (P<0.05).Conclusion The major risk factors of multiple trauma patients with MODS are shock without being adjusted in time after admission,high ISS and APACHEⅢ scores.It should be paid attention to the patients who have the risk factors mentioned above after their admission in case of the occurrence of MODS .%目的：探讨多发伤患者并发多器官功能障碍综合征（ MODS）的危险因素，为临床诊治提供参考。方法回顾性分析154例多发伤患者临床资料，根据患者有无并发MODS分为MODS组（84例）与非MODS组（70例），分析相关因素。结果 MODS组患者在入院后6 h之内休克纠正率、格拉斯哥评分（GCS）、红细胞计数、血小板计数明显低于非MODS组（ P＜0．05）；患者年龄、创新严重程度评分（ ISS ）、APACHEⅢ评分、白细胞计数、随机血糖高于非MODS组（ P＜0．05）；非条件多因素logistic回归分析结果显示患者入院后6 h之内休克未纠正、ISS分值高、APACHEⅢ评分高是患者并发MODS 的独立危险因素（ P ＜0．05）；MODS 组死亡率为55．95％，高于非MODS组的14．29％（ P＜0．05）；MODS发生率与死亡率呈正相关（ P＜0．05）。结论多发伤患者并发MODS的危险因素主要为入院后未及时纠正休克、ISS分值及APACHEⅢ评分高，对存在以上危险因素的患者入院后要注意MODS的发生。