下肢动脉硬化闭塞症坏疽期死亡危险因素分析.docVIP

下肢动脉硬化闭塞症坏疽期的死亡危险因素分析 　　摘要：目的探讨下肢动脉硬化闭塞症坏疽期患者的病情特点，分析其死亡危险因素，指导临床防治。方法回顾性分析111例下肢动脉硬化闭塞症坏疽期患者的临床资料，对可能与死亡相关的因素进行单因素及多因素分析。结果111例患者中死亡19例，病死率17%，单因素分析显示，低蛋白血症、坏疽类型、白细胞计数、血小板计数、心功能、血红蛋白、血糖为影响患者死亡的危险因素P0.05；多因素分析显示，上述各自的OR分别为12.117、10.015、9.360、5.232、9.551、6.214、4.288。结论下肢动脉硬化闭塞症坏疽期预后与坏疽类型有关，低蛋白血症、局部感染是坏疽期病情恶化的特点，应针对性地加以干预。 　　关键词：下肢动脉硬化闭塞症；坏疽；低蛋白血症；感染 　　Correlated Risk Factors of Death in Lower Extremity Arteriosclerosis Occlusion Syndrome with Gangrene 　　ZHANG Lin-qiang， JIANG Zhi-jia，LI Yan-xun， SUN Jin-jin 　　（Department of Vascular Surgery，Second Hospital Affiliated to Tianjin Medical University， Tianjin 300211， China） 　　Abstract：ObjectiveTo study the clinical characteristics of the lower extremity arteriosclerosis occlusion syndrome with gangrene and analyze the causes of hospitalized death so as to guide the prevention and treatment. MethodsThe clinical data of 111 cases of arteriosclerosis obliterans patients with gangrenous were retrospectively analyzed，then the univariate analysis and multivariate analysis were performed for the causes of hospitalized death. ResultsTotally 111 cases of patients，19 cases died in the hospital with the mortality of 17%. The univariate analysis showed that hypoproteinemia， the type of gangrene， leukocyte， platelet count， cardiac function， haemoglobin and fasting blood glucose were the risk factors of the hospitalized death（P0.05）；The multivariate analysis showed the OR values above were 12.117， 10.015， 9.360， 5.232， 9.551， 6.214， 4.288， respectively. ConclusionThe prognosis of lower extremity arteriosclerosis occlusion syndrome with gangrene is related to the type of gangrene. Hypoproteinemia and local infection are the characteristics of lower limb gangrene， and it is necessary for the hospital to formulate the targeted interventions. 　　Key words：Arteriosclerosis occlusion syndrome； Gangrene； Hypoproteinemia；Infection 　　下肢动脉硬化闭塞症是全身血管疾病的局部表现，起病隐匿，容易发展为坏疽，尤其是湿性坏疽，单靠抗感染、换药难以促进其愈合，国外报道1年内有30%需要接受截肢或截趾治疗[1]，5年死亡率将近60%[2]。目前国内