急诊监护病房危重患者贫血特征分析

目的:探讨危重病患者合并贫血的临床特点及其预后。方法:入选2009年7月至2011年4月急诊重症监护病房(EICU)288例危重病患者,分析其不同性别和年龄段贫血的发生率。按血红蛋白(Hb)水平分为贫血组和对照组,比较其临床特点及预后。住院期间对照组患者Hb低于参考值定义为新发生的贫血,比较住院期间新发生的贫血患者同Hb正常患者的不同临床特点及预后。结果:老年患者占EICU患者的60.8%,不同性别和年龄组之间贫血的发生率无差别。入院时即有贫血的患者占48.3%(男47.0%,女50.0%)。入院贫血组患者所需机械通气和肾脏替代治疗较对照组增加(P<0.01),其病死率高于对照组(P<0.05),2组住院时间无统计学差异。住院期间新出现的贫血患者同对照组相比,机械通气和肾脏替代治疗较对照组增加(P<0.05或P<0.01),2组住院时间和病死率无统计学差异。结论:急诊危重病患者常合并贫血,入院贫血和住院期间新发贫血患者机械通气和肾脏替代治疗者更多。贫血患者的临床预后更差。

The characteristics of patients with anemia in emergency intensive care unit

Objective To investigate the clinical characteristics of severe ill patients with anemia and its prognosis. Methods Two hundred and eighty-eight severe ill patients from July 2009 to April 2011 were enrolled in this study. The incidence of anemia in different gender and age groups were analyzed. According to hemoglobin （Hb） level, the patients were divided into anemia group and non-anemia group, and their clinical features and prognosis were compared. The new onset anemia is defined as Hb less than the value in non-anemia group during hospitalized period. The clinical features and prognosis of the new onset anemia group and non-anemia group were compared. Results Elderly patients accounted for 60.8% of the patients in emergency intensive care unit, and there was no difference between different gender and age groups. The patients had anemia at admission accounted for 48.3% （male 47.0%, female 50.0%）. The patient with anemia at admission group required more mechanical ventilation and renal replacement therapy （P〈0.01） and had higher mortality rate than that in non-anemia group （P〈0.05）, but the two groups did not show statistically significant difference in length of hospital stay. The new onset anemia group required more mechanical ventilation （P〈0.05） and renal replacement therapy （P〈0.01） when compared with non-anemia group, but did not show statistically significant difference in mortality rate and length of hospital stay. Conclusions Severe ill patients, in emergency department having anemia are very common. Patients in anemia group need more mechanical ventilation and renal replacement therapy, whether the anemia is present at admission or occurred during hospitalized period. The patients associated with anemia show worser clinical prognosis.