摘要
目的：探讨腹部手术对全身炎性反应综合征（ＳＩＲＳ）的影响．方法：我们分析了８２例腹部术后在ＩＣＵ留住患者，其中，男 ５０ 例，女 ３２ 例，平均在 ＩＣＵ留住 ８．８ 天。 入 ＩＣＵ时 ＡＰＡＣＨＥ Ⅱ评分平均为 １０．８分．按临床资料分为ＳＩＲＳ组和非ＳＩＲＳ组，ＳＩＲＳ组中无明显感染者归为非感染性ＳＩＲＳ，有明确感染者分别诊断为全身性感染和感染性休克．结果：按临床资料非 ＳＩＲＳ组 ＡＰＡＣＨＥ Ⅱ评分平均为 ７．２１分， ＳＩＲＳ组平均为 １３．３４． ＳＩＲＳ组发生率为６１．０％（５０／８２），ＳＩＲＳ组病死率为１８％（９／５０），而非ＳＩＲＳ组病死率为３．１％（１／３２），明显低于ＳＩＲＳ组，二者之间有极显著差异（Ｐ＜０．０１）。急诊手术组ＳＩＲＳ发生率６４．７％（２２／３４），其中感染性ＳＩＲＳ发生率为５４．５％（１２／２２），病死率为２２．７％９５／２２），择期手术组ＳＩＲＳ发生率为５８．３％（２８／４８），其中感染性ＳＩＲＳ发生率为３２．１％（９／２８），病死率为 １４．３％（４／２８），急诊手术组较择期手术组的 ＳＩＲＳ和感染性 ＳＩＲＳ发生率及死亡率均明显增高．结论：按临床资料，ＡＰＡ ＣＨＥⅡ评分在７．
Objective : To find out the influence of abdominal operation to the systemic inflammatory response syndrome(SIRS). Method: We analyzed 82 cases of ICU patients, which had been given abdominal operation in hospital, 50 cases were male, 32 cases were female, they had hospitalized in ICU for 8.8 days averagely. The APACHE II score was 10.8 averagely. when they All the patients were divided into SIRS group and non-SIRS group with the clinical materials hospitalized in ICU. IN SIRS group, the patients without clear infection belonged to noninfective SIRS group, while the patients with clear infection named as systemic infection and infective shock respectively. Resultst By the clinical materials the APACHE II score in non- SIRS group was 7.21, in SIRS group was 13.34 IN SIRS group, the incidence was 61.0%(50/82), The mortality in SIRS group, was 18%(9/50) The mortality in non- SIRS group was 3. l%(l/32), It was much lower than the SIRS group and there was significant difference between the two groups(P＜0.01 ). The SIRS incidence in emergent operation group was 64.7%(22/34), infective SIRS incidence was 54.5%(12/22), mortality was 22.7%(5/22); While the SIRS incidence in selective operation group was 58.3%(28/48), infective SIRS incidence was 32.1%(9/28), mortality was 14.3%(4/28). The incidence and mortality of SIRS and infective SIRS in emergent operation group were much higher than those in selective operation group. Conclusion : There was a marked SIRS occurrence tendency when the patients APACHE II score was above 7.21. We should aim directly at the occurrence principle of SIRS and administer it to the therapy accordingly. We also concluded five disease with high risk of occurring SIRS and factors inclined to evoke SIRS after abdominal operation.
出处
《伤残医学杂志》
2001年第2期15-18,共4页
Medical Journal of Trauma and Disability
关键词
全身炎性反应综合征
感染
腹部外科
The systemic inflammatory response syndrome Operation Infection Abdominal surgery
