摘要
目的 探讨严重多发伤继发急性肾损伤(AKI)患者临床特点、急救系统风险预测模型(DAVROS)评分联合改良早期预警评分(MEWS)变化,并分析严重多发伤继发AKI的危险因素。方法 回顾性分析2019年1月至2022年12月本院收治的78例严重多发伤患者临床资料,根据患者入院7 d内是否继发AKI分为AKI组16例、非AKI组62例。记录两组临床特点资料、DAVROS评分、MEWS评分,并采用多因素Logstic回归分析分析严重多发伤继发AKI的危险因素。结果 AKI组休克、使用造影剂、甘露醇用量及晶体液输注量≥4000 mL/24 h的患者明显多于非AKI组,创伤严重程度(ISS)评分、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)评分均高于非AKI组,差异有统计学意义(P<0.05);AKI组DAVROS评分、MEWS评分均明显高于非AKI组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,休克、使用造影剂、甘露醇用量、晶体液输注量≥4000 mL/24 h、APACHEⅡ评分、DAVROS评分、MEWS评分均是严重多发伤继发AKI的危险因素(P<0.05)。结论 休克、使用造影剂、甘露醇用量、晶体液输注量≥4000 mL/24 h、APACHEⅡ评分、DAVROS评分、MEWS评分均是严重多发伤继发AKI的危险因素,临床上应予以重视。
Objective To study the clinical characteristics,changes of first aid systemic risk prediction model(DAVROS)score and the improved early warning score(MEWS)in patients with severe multiple injury secondary acute kidney injury(AKI),and the risk factors of severe multiple injuries secondary AKI were analyzed.Methods A retrospective analysis was conducted on the clinical data of 78 patients with severe multiple injuries admitted to our hospital from January 2019 to December 2022,based on whether the patients had secondary AKI within 7 days of admission,they were divided into an AKI group of 16 cases and a non-AKI group of 62 cases.The clinical characteristics,DAVROS score and MEWS score of the two groups were recorded,and the risk factors of secondary AKI were analyzed by Logstic regression analysis.Results The shock,use of contrast agent,dosage of mannitol and infusion amount of crystal solution≥4000 mL/24h in the AKI group patients were significantly more than those in non-AKI group,the injury severity score(ISS),Acute Physiology and Chronic Health Status ScoreⅡ(APACHEⅡ)were higher than those in non-AKI group,with statistically significant(P<0.05).The DAVROS score and MEWS score in AKI group patients were significantly higher than those in the non-AKI group,with statistical significance(P<0.05).The Multivariate Logistic regression analysis showed that shock,use of contrast media,dosage of mannitol,infusion amount of crystal solution≥4000 mL/24 h,APACHEⅡscore,DAVROS score and MEWS score were all risk factors for secondary AKI in severe multiple injuries(P<0.05).Conclusion Shock,use of contrast media,dosage of mannitol,infusion amount of crystal solution≥4000 mL/24 h,APACHEII score,DAVROS score and MEWS score are all risk factors for AKI secondary to severe multiple injuries,which should be paid attention to clinically.
作者
毛文君
余美红
方苏红
MAO Wenjun;YU Meihong;FANG Suhong(Chun'an County First People's Hospital,Zhejiang 311700,China)
出处
《浙江创伤外科》
2023年第9期1615-1618,共4页
Zhejiang Journal of Traumatic Surgery
关键词
多发伤
急性肾损伤
急救系统风险预测模型评分
改良早期预警评分
危险因素
Multiple injuries
Acute kidney injury
First aid Systemic risk prediction model score
Improve early warning scoring
Risk factors
