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武警医学  2024, Vol. 35 Issue (12): 1013-1017    DOI:
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腹部创伤后发生脓毒症的危险因素
刘昕炜, 胡时栋, 达布西力特, 杜晓辉
100853 北京,解放军总医院第一医学中心普通外科医学部
Risk factors for sepsis after abdominal trauma
LIU Xinwei, HU Shidong, DA Buxilite, DU Xiaohui
Department of General Surgery, the First Medical Center of PLA General Hospital, Beijing 100853, China

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摘要 目的 探讨腹部创伤后患者发生脓毒症的危险因素,为腹部创伤的临床治疗提供科学依据。方法 选用美国重症监护医学信息数据库Ⅳ(MIMIC-Ⅳ)回顾性分析273例腹部创伤患者的临床资料,包括入院时的伤情信息、危重症评分、生命体征、主要实验室检查结果和临床治疗情况,采用单因素筛选,多因素logistic回归分析腹部创伤后发生脓毒症的危险因素。结果 logistic多元回归分析显示,腹部手术(OR=3.249,95%CI:1.525~6.918,P=0.002)、机械通气(OR=4.684,95%CI:2.262~9.699,P<0.001)、钙(OR=0.610,95%CI:0.446~0.836,P=0.002)、全身炎症反应综合征评分(SIRS)(OR=1.993,95%CI:1.280~3.104,P=0.002)、中心静脉导管(OR=2.438,95%CI:1.068~5.561,P=0.034)是腹部创伤后发生脓毒症的独立危险因素。结论 腹部创伤后发生脓毒症与腹部手术、机械通气、钙离子水平、SIRS评分、中心静脉导管密切相关,临床中应注意及时评估腹部创伤患者发生脓毒症的风险,并做好监测和预防。
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刘昕炜
胡时栋
达布西力特
杜晓辉
关键词 腹部损伤脓毒症危险因素预后外科手术    
AbstractObjective To explore the risk factors for sepsis in patients with abdominal trauma and to provide scientific basis for the clinical treatment of abdominal trauma. Methods The clinical data of 273 patients with abdominal trauma were retrospectively analyzed using the MIMIC-Ⅳ database, including the injury information at admission, severity scores, vital signs, major laboratory test results, and clinical treatment. Single-factor screening and multivariate logistic regression analysis were used to analyze the risk factors for sepsis after abdominal trauma. Results Logistic multiple regression analysis showed that surgical operation (OR=3.249,95%CI:1.525-6.918,P=0.002), mechanical ventilation (OR=4.684,95%CI:2.262-9.699,P<0.001), calcium (OR=0.610,95%CI:0.446-0.836,P=0.002), SIRS score (OR=1.993,95%CI:1.280-3.104,P=0.002), and central venous catheterization (OR=2.438,95%CI:1.068-5.561,P=0.034) were independent risk factors for sepsis after abdominal trauma. Conclusions The occurrence of sepsis after abdominal trauma is closely related to surgical operation, mechanical ventilation, calcium, SIRS score, and central venous catheterization. In clinical practice, attention should be paid to timely evaluation of the risk of sepsis in patients with abdominal trauma, and monitoring and prevention should be implemented accordingly.
Key wordsabdominal trauma    sepsis    risk factor    prognosis    surgical operation   
收稿日期: 2024-04-01     
ZTFLH: R641  
基金资助:军队某课题资助
通讯作者: 杜晓辉,E-mail: duxiaohui301@sina.com   
作者简介: 刘昕炜,硕士研究生,主治医师。
引用本文:   
刘昕炜, 胡时栋, 达布西力特, 杜晓辉. 腹部创伤后发生脓毒症的危险因素[J]. 武警医学, 2024, 35(12): 1013-1017. LIU Xinwei, HU Shidong, DA Buxilite, DU Xiaohui. Risk factors for sepsis after abdominal trauma. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(12): 1013-1017.
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