作　　者： ;

机构地区： 广东药科大学

出　　处： 《广东药科大学学报》 2019年第6期823-828,共6页

摘　　要： 目的探讨成人重症肺炎的临床特征及不良临床结局的风险因素以指导临床救治。方法回顾性分析成人重症肺炎患者的临床电子病例资料,从中筛选出57个风险因素进行单因素和多因素Logistic回归分析,得到成人重症肺炎不良临床结局(死亡/自动出院)的独立风险因素。结果共纳入179例成人重症肺炎患者,其中经常规治疗后院内死亡率为29.05%;自动出院率为27.93%;19.55%的患者经治疗后病情好转出院,但仍需继续接受治疗;只有23.46%的患者治愈后出院。经Logistic回归分析,肾上腺素、纠正酸中毒药、抗心律失常药、治疗期间发生并发症、高CRP水平等因素是成人重症肺炎不良临床结局的独立风险因素。结论肾上腺素适应证、酸中毒、心律失常、并发症、高CRP水平等因素会显著增加成人重症肺炎患者不良临床结局的发生风险,积极预防和控制这些风险因素将有利于改善成人重症肺炎患者的临床结局。 Objective To investigate the clinical characteristics of adult severe pneumonia and the risk factors of adverse clinical outcomes for guiding clinical treatment.Methods The clinical electronic data of adult patients with severe pneumonia were analyzed retrospectively.57 risk factors were selected and analyzed by univariate and multivariate Logistic regression analysis.The independent risk factors of adverse clinical outcomes(death/automatic discharge)of adult severe pneumonia were obtained.Results A total of 179 adult patients with severe pneumonia were included,the in-hospital mortality was 29.05%after routine treatment and the automatic discharging rate was 27.93%.19.55%of the patients were discharged with condition improved,but still needed to continue treatment.Only 23.46%of the patients were cured and discharged from the hospital.Logistic regression analysis showed that"epinephrine","correcting acid poison","antiarrhythmic drugs","complications during treatment"and"high CRP level"were independent risk factors for adverse clinical outcomes of adult severe pneumonia.Conclusion The factors such as epinephrine indication,acidosis,arrhythmia,complications,and high CRP level can significantly increase the risk of adverse clinical outcomes in adult severe pneumonia.Active prevention and control of these risk factors will be helpful to improve the clinical outcomes of adult patients with severe pneumonia.

关 键 词： 重症肺炎 临床特征 风险因素 LOGISTIC回归分析

分 类 号： [R563.1;R969.3]

领　　域： []