危重症患者应激性溃疡发生的危险因素分析

目的：分析危重症患者发生应激性溃疡的危险因素,为危重症患者应激性溃疡的合理预防提供理论依据。方法：回顾性分析2011-01-2013-12入住我院急诊重症监护病房患者的病例资料,以是否发生应激性溃疡将患者分为两组,以机械通气、凝血功能障碍、低血压、颅脑损伤、肝功能衰竭、肾功能衰竭、肠内营养、糖皮质激素的应用、创伤、饮酒史、消化道溃疡病史为变量,分析上述变量在两组患者中的差别,采用Logistic回归分析方法确定应激性溃疡发生的危险因素。结果：两组患者在机械通气、凝血功能障碍、低血压、颅脑损伤、肝功能衰竭和创伤方面存在差异（P〈0.05）,机械通气、凝血功能障碍、低血压和颅脑损伤是危重症患者应激性溃疡发生的危险因素。结论：当危重症患者并发存在机械通气、凝血功能障碍、低血压和颅脑损伤时应加强应激性溃疡的预防治疗。

Analysis of risk factors for stress ulcer in critically ill patients

Objective： To analysis of risk factors for stress ulcer in critically ill patients, which can provided consultation for rational prophylaxis. Method：Clinical data of patients admitted to our EICU from January 2011 to December 2013 was investigated in the retrospective study. Depending on the occurrence of stress ulcer, the patients were divided into two groups. With variables of occurrence of mechanical ventilation, coagulopathy, hypotension, head trauma, hepatic failure, renal failure, trauma , application of enteral nutrition and glucocorticoid, history of alcoholism and peptic ulcer, we identified the significant difference in the variables in the two groups and risk factors for Stress ulcer with logistic regression analysis. Result：Occurrence of mechanical ventilation, coagulopathy, hypotension, head trauma, hepatic failure and trauma are different in the two groups. Occurrence of mechanical ventilation, coagulopathy, hypotension and head trauma are risk factors for Stress ulcer in critically ill patients. Conclusion：Stress ulcer prophylaxis is necessary when critically ill patients are combined with mechanical ventilation,coagulopathy,hypotension and head trauma.