Zhang Hong, Chen Dan, Wang Lihua, Li Bing
Nephrology Department, Taizhou Hospital of Zhejiang Province, Linhai, Zhejiang 317000, China.
Special Ward, Taizhou Hospital of Zhejiang Province, Linhai, Zhejiang 317000, China.
Evid Based Complement Alternat Med. 2021 Nov 3;2021:5754114. doi: 10.1155/2021/5754114. eCollection 2021.
Severe trauma can cause systemic reactions, leading to massive bleeding, shock, asphyxia, and disturbance of consciousness. At the same time, patients with severe trauma are at high risk of sepsis and acute renal injury. The occurrence of complications will increase the difficulty of clinical treatment, improve the mortality rate, and bring heavy physical and mental burdens and economic pressure to patients and their families. It is of great clinical significance to understand the high risk factors of sepsis and AKI and actively formulate prevention and treatment measures. In this study, the clinical data of 85 patients with severe trauma were analyzed by univariate and multivariate logistic regression to identify the risk factors leading to sepsis or AKI and analyze the prevention and treatment strategies. The results showed that multiple injuries, APACHE II score on admission, SOFA score on admission, and mechanical ventilation were independent influencing factors of sepsis in patients with severe trauma, while hemorrhagic shock, APACHE II score on admission, CRRT, and sepsis were independent influencing factors of AKI in patients with severe trauma. Severe trauma patients complicated with sepsis or AKI will increase the risk of death. In the course of treatment, prevention and intervention should be given as far as possible to reduce the incidence of complications.
严重创伤可引起全身反应，导致大量出血、休克、窒息及意识障碍。同时，严重创伤患者发生脓毒症和急性肾损伤的风险较高。并发症的发生会增加临床治疗难度，提高死亡率，并给患者及其家庭带来沉重的身心负担和经济压力。了解脓毒症和急性肾损伤的高危因素并积极制定防治措施具有重要的临床意义。本研究通过单因素及多因素logistic回归分析85例严重创伤患者的临床资料，以识别导致脓毒症或急性肾损伤的危险因素并分析防治策略。结果显示，多发伤、入院时APACHE II评分、入院时SOFA评分及机械通气是严重创伤患者发生脓毒症的独立影响因素，而失血性休克、入院时APACHE II评分、连续性肾脏替代治疗（CRRT）及脓毒症是严重创伤患者发生急性肾损伤的独立影响因素。严重创伤合并脓毒症或急性肾损伤的患者死亡风险会增加。在治疗过程中，应尽可能给予预防和干预，以降低并发症的发生率。
