胃肠相关急腹症患者发生感染性休克的临床研究

发布时间：2019-03-13 10:11

【摘要】：目的探讨胃肠相关急腹症并发感染性休克的临床特点和危险因素。方法选择2009年5月-2014年12月医院就诊的胃肠相关性急腹症并发感染性休克的患者82例,观察感染性休克的临床表现、体征;病原菌类型与感染性休克严重程度的关系;手术与非手术治疗的预后情况;发生感染性休克危险因素。结果胃肠相关急腹症并发感染性休克患者主要临床表现为表情淡漠、烦躁不安、四肢苍白厥冷,体征主要为低血压、心率慢、尿量少,体温不是判断感染性休克的主要标准;革兰阴性菌感染占64.63%,革兰阳性菌感染患者中轻度感染性休克的比例65.52%,革兰阴性菌感染患者中轻度感染性休克的比例15.09%,差异有统计学意义(P0.05);革兰阳性菌感染患者中重度感染性休克的比例13.79%,革兰阴性菌感染患者中重度感染性休克的比例60.38%,差异有统计学意义(P0.05);手术治疗总治愈率85.29%,保守治疗总治愈率35.71%,差异有统计学意义(P0.05);年龄、原发病类型、病程时长、合并器官衰竭个数、慢性病史、治疗时机为引起感染性休克的危险因素(P0.05)。结论诊治胃肠相关性急腹症并发感染性休克时应当关注相关危险因素、临床表现和体征,一经确诊应当早期抗休克、手术和抗感染治疗。
[Abstract]:Objective to investigate the clinical characteristics and risk factors of gastrointestinal-associated acute abdomen complicated with septic shock. Methods 82 patients with gastrointestinal-associated acute abdomen complicated with septic shock were selected from May 2009 to December 2014. The clinical manifestations and signs of septic shock were observed, and the relationship between pathogenic bacteria types and severity of septic shock was observed. Prognosis of surgical and non-surgical treatment; risk factors for septic shock. Results the main clinical manifestations of gastrointestinal-associated acute abdomen complicated with septic shock were low expression, restlessness, pale and cold limbs, low blood pressure, slow heart rate, low urine volume, and body temperature was not the main criterion for judging septic shock. Gram-negative bacteria infection accounted for 64.63%, Gram-positive bacteria infection in patients with mild septic shock rate of 65.52%, Gram-negative bacteria infection in patients with mild septic shock rate 15.09%, the difference was statistically significant (P0.05). The proportion of moderate-severe septic shock was 13.79% in Gram-positive bacteria-infected patients and 60.38% in Gram-negative bacteria-infected patients (P0.05). The total cure rate of surgical treatment was 85.29%, and the total cure rate of conservative treatment was 35.71%, the difference was statistically significant (P0.05). Age, type of primary disease, duration of disease, number of complicated organ failure, chronic history and treatment timing were risk factors for septic shock (P0.05). Conclusion in the diagnosis and treatment of gastrointestinal-associated acute abdomen complicated with septic shock, we should pay attention to the related risk factors, clinical manifestations and signs, and should be treated with early anti-shock, operation and anti-infection as soon as the diagnosis is confirmed.
【作者单位】：北京大学国际医院胃肠外科;丹东市第一医院普外一科;
【分类号】：R656.1

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