细菌性肝脓肿合并糖尿病患者出现脓毒性休克的危险因素分析
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1.蚌埠医学院第一附属医院;2.南京医科大学第一附属医院

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Analysis of risk factors for septic shock in patients with Pyogenic liver abscess and diabetes
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    摘要:

    [摘要] 目的:通过分析细菌性肝脓肿合并糖尿病患者脓毒性休克的临床特征,探究预测休克的早期危险因素。方法:收集我院2017年1月至2021年4月经CT引导下穿刺诊断为肝脓肿的240例糖尿病患者的临床资料,依据住院期间是否出现脓毒性休克划分为休克组及非休克组。纳入患者初诊时一般资料,首诊症状、生命体征、腹部CT及血生化指标等,对休克的危险因素综合分析。结果:①休克组与非休克组一般资料比较,休克组年龄更高,且存在显著差异(P<0.05)。②休克组患者较非休克组患者呼吸频率、心率及最高体温均显著增加,差异具有统计学意义(P<0.05),平均动脉压及脓肿的CT表现差异无统计学意义(P>0.05)。③血检测结果比较,休克组白细胞计数及中性粒细胞百分比较非休克组显著增加,血小板计数显著下降。④休克组较非休克组凝血酶原时间、PT国际化标准化比值、部分凝血活酶活化时间(秒)、凝血酶时间均显著延长(P<0.05)。⑤经二元logistic回归分析显示呼吸频率、最高体温及凝血酶原时间是脓毒性休克的独立预测因素。结论:初诊时患者呼吸频率、最高体温及凝血酶原时间可为休克的早期识别提供重要预测价值。

    Abstract:

    [Abstract] Objective: By analyzing the clinical characteristics of septic shock in patients with Pyogenic liver abscess complicated with diabetes, the early risk factors for shock prediction were explored. Methods: The clinical data of 240 diabetic patients with liver abscesses assessed by computerized tomography (CT) in our hospital from January 2017 to April 2021 were collected. According to whether with septic shock occurred or not during hospitalization, they were divided into shock group and non-shock group.The general informations of patients at the first visit, symptoms, basic vital signs, abdominal CT and blood biochemical indicators, etc were analyzed to identify the risk factors of shock. Results: ①Comparing the general data of two groups, there was a significant difference in age (P<0.05). ②There were significant differences in symptoms, respiratory rate, heart rate, and maximum body temperature between the two groups of patients (P<0.05), and the differences in mean arterial pressure and CT manifestations of absess were not statistically significant (P>0.05). ③Compared with the blood test results, the white blood cell count and neutrophil percentage in the shock group were significantly increased compared with the non-shock group, and the platelet count was significantly decreased. ④The prothrombin time, PT international standardized ratio, partial thromboplastin activation time (seconds), and thrombin time were significantly prolonged in the shock group than in the non-shock group (P<0.05). ⑤The binary logistic regression analysis showed that respiratory rate, maximum body temperature and prothrombin time were independent predictors of septic shock. Conclusion: The patient's respiratory rate, maximum body temperature and prothrombin time at the first diagnosis can provide important predictive value for the early identification of shock.

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  • 收稿日期:2023-09-24
  • 最后修改日期:2024-04-16
  • 录用日期:2024-06-14
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