严重烧伤早期血糖变化多因素分析及预后影响

发布时间：2018-04-14 17:33

本文选题：早期血糖 + 因素　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:分析总结近年来我科重度以上烧伤病人早期血糖变化情况,探讨严重烧伤早期血糖变化的影响因素,及其对临床预后的影响,为今后临床诊治提供参考借鉴。方法:收集自2013年1月至2016年5月我院烧伤整形外科所收治的122例重度和特重度烧伤患者的临床资料,包括患者的年龄、性别、有无休克延迟复苏、烧伤原因、烧伤面积、吸入性损伤发生率、早期随机血糖、全身性感染发生率、死亡率、住院时间、感染部位数量以及MODS发生率。应用SPSS19.0统计学软件进行T检验等统计分析.结果:通过单因素分析,烧伤面积与早期血糖具有线性关系,相关系数R2=0.534,P0.05;各年龄组早期随机血糖对比,差异具有统计学意义(F=6.91,P0.05);休克延迟复苏组和非休克延迟复苏组早期血糖对比,差异有统计学意义(T=3.58,P0.05);不同程度的吸入性损伤间烧伤早期血糖对比,差异具有统计学意义(F=24.79,P0.05);不同的烧伤原因间烧伤早期血糖对比,差异具有统计学意义(F=7.02,P0.05)。但经COX回归分析,显示只有休克延迟复苏、重度吸入性损伤、III度烧伤面积、深II度烧伤面积四个因素与烧伤早期血糖变化相关联,血糖异常组和正常组间对比,住院时间、全身感染发生率、感染部位数量、死亡率差异具有统计学意义(P0.05),血糖异常组住院时间大于正常组,异常组全身感染发生率高于正常组,异常组感染部位数量多于正常组,异常组死亡率高于正常组,多器官功能障碍发生率差异无统计学意义(X~2=2.064,P0.05)。结论:(1)烧伤深度、面积、休克延迟复苏、重度吸入性损伤四个因素是影响严重烧伤早期血糖变化的主要因素。(2)患者性别、年龄以及烧伤原因与严重烧伤早期血糖变化无相关联。(3)早期血糖升高增加烧伤患者死亡率、住院时间、感染发生率,但对多器官功能障碍发生率影响较小。
[Abstract]:Objective: to analyze and summarize the changes of early blood glucose in severe burn patients in our department in recent years, and to explore the influencing factors of early blood glucose change and its influence on clinical prognosis in order to provide reference for clinical diagnosis and treatment in the future.Methods: from January 2013 to May 2016, 122 patients with severe and severe burn, including age, sex, delayed resuscitation of shock, cause of burn, area of burn, were collected.Incidence of inhalation injury, early randomized blood sugar, systemic infection, mortality, length of stay, number of sites infected, and incidence of MODS.The T test and other statistical analysis were carried out with SPSS19.0 software.Results: by univariate analysis, there was a linear relationship between burn area and early blood glucose, and the correlation coefficient was R _ (2) 0.534 (P _ (0.05)).The difference was statistically significant (P 0.05), the difference between delayed shock resuscitation group and non-shock delayed resuscitation group was statistically significant.The difference was statistically significant (P 0.05), and the difference was statistically significant among different burn causes (P 0.05).However, COX regression analysis showed that only four factors, such as delayed resuscitation of shock, severe inhalation injury and deep second-degree burn area, were associated with the changes of blood glucose in the early stage of burn. The blood glucose abnormality group and the normal group were compared, and the length of stay was compared.The incidence of systemic infection, the number of infected sites and the mortality rate were significantly different (P 0.05). The duration of hospitalization in abnormal blood glucose group was longer than that in normal group, the incidence of systemic infection in abnormal group was higher than that in normal group, and the number of infected sites in abnormal group was more than that in normal group.The mortality rate in abnormal group was higher than that in normal group, and there was no significant difference in the incidence of multiple organ dysfunction.Conclusion (1) depth of burn, area of burn, delayed resuscitation of shock, severe inhalation injury are the main factors influencing the change of blood glucose in the early stage of severe burn.Age and the cause of burn were not associated with the changes of blood glucose in severe burn. (3) the increase of early blood glucose increased the mortality, hospital stay and infection rate of burn patients, but had little effect on the incidence of multiple organ dysfunction.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R644

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