急诊科脓毒症相关性肺损伤和肾损伤的发病情况及预后分析

摘要

Objective To explore the relationship between sepsis-associated lung injury and kidney injury and prognosis in emergency department.Methods Clinical data of 232 patients with sepsis in emergency department were analyzed,incluing the general information lung injury and renal injury incidence,sequebtial organ failure assessment(SOFA) score in the first day of admission and so on.Recovery of the capacity and antibiotic therapy were conducted.Mechanical ventilation and renal replacement therapy were conducted for some critically ill patients,and prognosis was analyzed.Results The incidence of renal injury was 33.62％ (78/232) in 232 patients with sepsis,which accounted for the highest proportion,and the mortality rate was 11.64％ (27/232).Lung injury accounted for 21.98％ (51/232) and the mortality rate was 14.66 ％ (34/232).Lung injury combined with renal injury accounted for 13.36％ (31/232) and the mortality rate was 10.34％ (24/232).SOFA score in the first day of admission,simple lung injury and lung injury combined with renal injury were associated with poor prognosis of sepsis (P ＜ 0.05).Conclusion The incidence of sepsis-associated renal injury in the emergency department is high,while the mortality rate of sepsis-associated lung injury is high.SOFA score in the first day of admission,simple lung injury and lung injury combined with renal injury are associated with poor prognosis of sepsis.%目的 探讨急诊科脓毒症相关性肺损伤和肾损伤的发病情况及其与预后间的关系.方法 收集232例我科收治的脓毒症患者,统计一般资料、肺损伤和肾损伤发病情况、入院第一天序贯器官衰竭估计(SOFA)评分等,对其行容量复苏、抗生素治疗,部分重症患者行机械通气及肾脏替代治疗等,并作预后分析.结果 232例脓毒症患者中,发生肾损伤者占33.62％(78/232),比例最高,死亡率为11.64％(27/232);发生肺损伤者占21.98％ (51/232),死亡率为14.66％ (34/232);发生肺损伤合并肾损伤者占13.36％ (31/232),死亡率为10.34％ (24/232);其中入院第一天SOFA评分、单纯肺损伤及肺损伤合并肾损伤与脓毒症的不良预后相关(P＜0.05).结论 急诊科脓毒症相关性肾损伤发病率高,脓毒症相关性肺损伤病死率高,入院第一天SOFA评分、单纯肺损伤及肺损伤合并肾损伤与脓毒症的不良预后相关.