低蛋白血症对神经重症患者肺部感染的预后影响分析
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摘要
目的了解低蛋白血症对神经重症患者肺部感染的预后影响。方法将2010年6月至2016年6月该院神经内科重症监护病房(NICU)收治的有肺部感染且痰培养阳性的已出院患者316例作为研究对象。将肺部感染合并低蛋白血症患者198例作为试验组,且根据血清清蛋白水平分为轻、中、重度,分别为50、67、81例。肺部感染未合并低蛋白血症患者118例作为对照组,对两组患者的预后进行分析。结果试验组急性生理学及慢性健康状况评分(APACHEⅡ)、平均住院时间、NICU住院时间、患者疾病转归与对照组比较,差异均有统计学意义(P=0.014、0.010、0.047、0.013)。结论神经重症患者肺部感染合并低蛋白血症预后差,有效防治低蛋白血症有可能预防和减轻肺部感染,对患者的成功救治及预后有积极意义。
Objective To Understand the influence of hypoproteinemia on neurological intensive patients with pulmonary infection.Methods A total of 316 discharged patients with pulmonary infection and positive sputum culture admitted to the Intensive Care Unit of Department of Neurology,the First Affiliated Hospital of Chongqing Medical University from June 2010 to June 2016 were selected as the research subject.A total of 198 patients with hypoproteinemia for neurological intensive patients with pulmonary infection were selected as experimental group.According to the level of serum albumin,the patients were divided into mild(50 cases),moderate(67 cases)and severe cases(81 cases).A total of 118 patients with pulmonary infection unconsolidated with low albumin were selected as the control group.Results Compared with the control group,there were statistically significant difference in the Acute Physiological and Chronic Health Score(APACHE Ⅱ),average stay and neurological intensive care unit(NICU)length of stay(P=0.014,0.047,0.013).Conclusion The prognosis of neurological intensive patients with pulmonary infection is poor.The effective prevention and treatment of hypoalbuminemia can prevent and alleviate pulmonary infection possibly,it has positive significance for the successful treatment and prognosis of patients.
Objective To Understand the influence of hypoproteinemia on neurological intensive patients with pulmonary infection.Methods A total of 316 discharged patients with pulmonary infection and positive sputum culture admitted to the Intensive Care Unit of Department of Neurology,the First Affiliated Hospital of Chongqing Medical University from June 2010 to June 2016 were selected as the research subject.A total of 198 patients with hypoproteinemia for neurological intensive patients with pulmonary infection were selected as experimental group.According to the level of serum albumin,the patients were divided into mild(50 cases),moderate(67 cases)and severe cases(81 cases).A total of 118 patients with pulmonary infection unconsolidated with low albumin were selected as the control group.Results Compared with the control group,there were statistically significant difference in the Acute Physiological and Chronic Health Score(APACHE Ⅱ),average stay and neurological intensive care unit(NICU)length of stay(P=0.014,0.047,0.013).Conclusion The prognosis of neurological intensive patients with pulmonary infection is poor.The effective prevention and treatment of hypoalbuminemia can prevent and alleviate pulmonary infection possibly,it has positive significance for the successful treatment and prognosis of patients.
引文
[1]刘光维,霍康,王学峰.神经科重症监护室肺部感染病原体调查及对护理工作的影响[J].中国中医急症,2009,18(3):473-475.
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[3]GATTA A.Hypoalbuminemia[J].Intern Emerg Med,2012,7(Suppl 3):S193-199.
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[5]SOCIETY AT.Infectious diseases society of America[Z].2005-01-03.
[6]VINCENT JL,DUBOIS MJ,NAVICKIS RJ,et al.Hypoalbuminemia in acute illness:is there a rationale for intervention?A metaanalysis of cohort studies and controlled trials[J].Ann Surg,2003,237(3):319-334.
[7]CASAER MP,MESOTTEN D,HERMANS G,et al.Early versus late parenteral nutrition in critically ill adults[J].N Engl J Med,2011,365(6):506-517.
[8]HARVEY SE,PARROTT F,HARRISON DA,et al.Trial of the route of early nutritional support in critically ill adults[J].N Engl J Med,2014,371(18):1673-1684.
[9]LIM SL,ONG KC,CHAN YH,et al.Malnutrition and its impact on cost of hospitalization,length of stay,readmission and 3-year mortality[J].Clin Nutr,2012,31(3):345-350.
[10]MIDDLETON MH,NAZARENKO G,NIVISON-SMITH I,et al.Prevalence of malnutrition and 12-month incidence of mortality in two Sydney teaching hospitals[J].Intern Med J,2001,31(8):455-461.
[11]LEIBOVITZ E,GIRYES S,MAKHLINE R,et al.Malnutrition risk in newly hospitalized overweight and obese individuals[J].Eur J Clin Nutr,2013,67(6):620-624.
[2]VIASUS D,GARCIA-VIDAL C,SIMONETTI A,et al.Prognostic value of serum albumin levels in hospitalized adults with community-acquired pneumonia[J].J Infect,2013,66(5):415-423.
[3]GATTA A.Hypoalbuminemia[J].Intern Emerg Med,2012,7(Suppl 3):S193-199.
[4]VIASUS D,GARCIA-VIDAL C,SIMONETTI A,et al.Prognostic value of serum albumin levels in hospitalized adults with community-acquired pneumonia[J].J Infect,2013,66(5):415-423.
[5]SOCIETY AT.Infectious diseases society of America[Z].2005-01-03.
[6]VINCENT JL,DUBOIS MJ,NAVICKIS RJ,et al.Hypoalbuminemia in acute illness:is there a rationale for intervention?A metaanalysis of cohort studies and controlled trials[J].Ann Surg,2003,237(3):319-334.
[7]CASAER MP,MESOTTEN D,HERMANS G,et al.Early versus late parenteral nutrition in critically ill adults[J].N Engl J Med,2011,365(6):506-517.
[8]HARVEY SE,PARROTT F,HARRISON DA,et al.Trial of the route of early nutritional support in critically ill adults[J].N Engl J Med,2014,371(18):1673-1684.
[9]LIM SL,ONG KC,CHAN YH,et al.Malnutrition and its impact on cost of hospitalization,length of stay,readmission and 3-year mortality[J].Clin Nutr,2012,31(3):345-350.
[10]MIDDLETON MH,NAZARENKO G,NIVISON-SMITH I,et al.Prevalence of malnutrition and 12-month incidence of mortality in two Sydney teaching hospitals[J].Intern Med J,2001,31(8):455-461.
[11]LEIBOVITZ E,GIRYES S,MAKHLINE R,et al.Malnutrition risk in newly hospitalized overweight and obese individuals[J].Eur J Clin Nutr,2013,67(6):620-624.