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目的探讨综合性医院急诊抢救危重病患者的死亡危险因素,为其防治提供参考。方法共纳入85例某院危重病经抢救无效死亡的患者,同时随机抽取90例该院危重病经抢救成功的患者作为对照组。应用多因素分析方法进行多因素分析。结果单因素分析结果显示:两组间年龄、就诊时间、心率、平均动脉压、循环功能异常、呼吸功能异常、肝功能异常、肾功能异常、电解质酸碱紊乱、白细胞数、APACHEⅡ评分差异比较存在统计学意义(P﹤0.05);而性别、体温及呼吸频率比较差异不明显(P﹥0.05)。多因素分析显示:高龄、循环功能异常、呼吸功能异常、肾功能异常、A-PACHEⅡ评分高是急诊危重病患者抢救无效死亡独立危险因素(P﹤0.05)。结论高龄、循环功能异常、呼吸功能异常、肾功能异常、APACHEⅡ评分高是急诊危重病患者抢救无效死亡独立危险因素,对急诊危重病患者的上述危险因素进行必要的干预具有重要的意义,可能降低其死亡的发生率。
Objective To investigate the risk factors of death in critically ill patients in the emergency department of general hospitals and provide references for their prevention and treatment. Methods A total of 85 patients died of critical illness in one hospital were randomly divided into two groups. At the same time, 90 patients were randomly selected as the control group. Multivariate analysis was performed using multivariate analysis. Results The results of univariate analysis showed that age, treatment time, heart rate, mean arterial pressure, circulatory dysfunction, abnormal respiratory function, abnormal liver function, renal dysfunction, electrolyte acid-base disorder, white blood cell count and APACHEⅡ score (P <0.05), while the difference of gender, body temperature and respiratory rate was not significant (P> 0.05). Multivariate analysis showed that elderly patients had abnormal circulatory function, abnormal respiratory function and renal dysfunction. The high A-PACHEⅡ score was an independent risk factor for emergency rescue in patients with critical illness (P <0.05). Conclusion The elderly, circulatory dysfunction, abnormal respiratory function, abnormal renal function, high APACHEⅡscore are independent risk factors for emergency rescue in emergency critical patients, and the necessary intervention for the above risk factors in emergency critical patients is of great significance and may be reduced The incidence of death.