rSIG休克指数与乳酸对创伤患者预后评估的预测价值

doi:10.3969/j.issn.1002-1949.2019.10.002

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摘要目的探讨rSIG（the Reverse Shock Index Multiplied by Glasgow Coma Scale Score)休克指数与乳酸对创伤患者预后的评估价值。方法收集2016年1月至2018年1月我院抢救室收治的1284例创伤患者临床资料，根据治疗结局及rSIG值分成存活组和死亡组，rSIG≤14.8组和rSIG＞14.8组，回顾性分析并比较各组生命体征、初始血乳酸、重症监护天数、病死率、急诊处理、输血次数、患者去向等指标，同时研究rSIG与乳酸间的关系，并分析其在预后评估中的意义。结果存活组患者的rSIG、住院天数显著大于死亡组，血乳酸水平显著低于死亡组［（23.2±8.3）vs.（11.3±9.4）,13.0（8.0，19.0）d vs. 4.0（2.0，18.8）d，1.5(1.0，2.5) mmol/L vs. 4.5（2.5，7.1）mmol/L，P＜0.01］；rSIG≤14.8组患者的血乳酸水平、重症监护天数、28 d病死率显著大于rSIG＞14.8组［2.6（1.5，4.3）mmol/L vs.1.5(0.9，2.3) mmol/L，11.0（6.5，19.0）d vs. 6.0（2.3，10.0）d，12.9% vs.0.8%，P<0.01］；创伤患者rSIG与乳酸水平呈负相关（r=-0.347，P＜0.01）；rSIG与初始血乳酸水平联合对患者28 d病死率的判断能力与两指标单独预测差异无统计学意义（Z=1.45，Z=1.75，P＞0.05）。结论 rSIG与乳酸对创伤患者伤情严重程度及预后有较好的预测价值，在临床上具有一定指导意义。

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	李鹏飞
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关键词 ： rSIG休克指数, 乳酸, 创伤, 预后

基金资助:全军后勤面上项目（CNJ14L002）；江苏省社会发展面上项目（BE2017720）

通讯作者: 聂时南（1964-），男，博士生导师，主任医师，教授，科主任，E-mail：shn_nie@sina.com。

作者简介: 李鹏飞（1992-），男，硕士研究生，E-mail：694618490@qq.com。

引用本文:

李鹏飞，杨志州，孙兆瑞，聂时南. rSIG休克指数与乳酸对创伤患者预后评估的预测价值[J]. 中国急救医学, 2019, 39(10): 929-934.
Li Peng-fei, Yang Zhi-zhou, Sun Zhao-rui, Nie Shi-nan. Predictive value of the Reverse Shock Index Multiplied by Glasgow Coma Scale Score (rSIG) and lactic acid in the evaluation of prognosis in patients with trauma. Chinese Journal of Critical Care Medicine, 2019, 39(10): 929-934.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2019.10.002 或 http://www.cnemergency.org.cn/CN/Y2019/V39/I10/929

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