重癥監(jiān)護(hù)病房急診搶救危重病患者的死亡危險因素分析

摘要： 目的探討影響重癥監(jiān)護(hù)病房急診搶救危重患者的死亡危險因素,為急診搶救危重患者提供參考依據(jù)。方法 2008年1月一2011年12月危重病患者68例納入本次研究。記錄患者基本情況,計算每位患者的急性生理與慢性健康評分(acute physiology and chronic health evaluationⅡ,APACHEⅡ)。測定患者血液中腦利鈉肽(brain natriuretic peptide,BNP)和心肌肌鈣蛋白(cTnT cardiac troponin,cT-nI)水平,隨訪患者28d的生存情況。根據(jù)28d患者存活情況將患者分為存活組和死亡組。對2組患者年齡、性別、血液BNP和cT-nI水平以及APACHEⅡ評分進(jìn)行統(tǒng)計分析。結(jié)果 28d時存活組和死亡組患者分別為43例(63.2%)和25例(36.8%)。死亡組和存活組的性別組間差異無統(tǒng)計學(xué)意義(P>0.05),而年齡、血液BNP和cT-nI水平以及APACHEⅡ評分組間差異均有統(tǒng)計學(xué)意義(P<0.01)。多因素分析結(jié)果顯示,年齡、血液BNP和cT-nI水平以及APACHEⅡ評分均為影響急診重癥患者死亡的危險因素。結(jié)論年齡、血液BNP和cT-nI以及APACHEⅡ評分為影響急診重癥患者死亡的危險因素,對于判斷急診重癥患者的臨床預(yù)后具有一定的指導(dǎo)意義。
Objective To explore the risk factors of death for critically ill patients during emergency treatment in intensive care unit,and to provide the consults for critically ill patients during emergency treatment.Methods Sixty - eight critically ill patients were included during 2008 and 2011 in the emergency department of hospital.The general conditions of each case were recorded and acute physiology and chronic health evaluationⅡ(APACHEⅡ) of each case were calculated.Levels of brain natriuretic peptide(BNP) and cTnT cardiac troponin(cT - nI) of each case were determined,and survival informations were followed.Cases were divided into survival group and death group according to the survival conditions on 28th day.Age,gender,levels of BNP and cT - nI,and APACHEⅡin both groups were statistically analyzed.Results There were respectively 43 cases(63.2%) in survival group and 25 cases(36.8%) in death group.The results of single factor analysis indicated that age,levels of BNP and cT - nI,and APACHEⅡwere statistically different in both groups(P <0.01) except gender (P > 0.05).The results of multi - factor analysis indicated that age,levels of BNP and cT - nI,and APACHE II were the risk factors of death for critically ill patients.Conclusion Age,levels of BNP and cT - nI,and APACHEⅡare the risk factors of death for critically ill patients,and they have the guiding significance to clinical prognosis for critically ill patients during emergency treatment.