多发伤并发持续炎症-免疫抑制-分解代谢综合征患者的临床特征及预后分析 |
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引用本文: | 唐庭轩,张聪,李松波,李镇文,唐良晟,邓海,吴涵,董黎明,唐朝晖.多发伤并发持续炎症-免疫抑制-分解代谢综合征患者的临床特征及预后分析[J].中华急诊医学杂志,2021,30(7):862-865. |
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作者姓名: | 唐庭轩 张聪 李松波 李镇文 唐良晟 邓海 吴涵 董黎明 唐朝晖 |
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作者单位: | 武汉科技大学医学院临床医学系1901 430081;华中科技大学同济医学院附属同济医院创伤外科,武汉 430030 |
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摘 要: | 目的:研究多发伤并发持续炎症-免疫抑制-分解代谢综合征(persistent inflammation, immunosuppression and catabolism syndrome, PICS)患者的临床特征及预后。方法:分析2019年1月至2020年7月间收治于同济医院创伤外科的1 083例多发伤患者的临床资...
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关 键 词: | 多发伤 持续炎症-免疫抑制-分解代谢综合征 临床特征 预后 |
A prospective study of clinical characteristics and prognosis in patients with persistent inflammation,immunosuppression and catabolism syndrome after polytrauma |
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Abstract: | Objective:To prospectively assess clinical characteristics, potential causes and prognosis in patients with persistent inflammation, immunosuppression and catabolism syndrome (PICS) after polytrauma.Methods:Totally 1 083 patients with polytrauma admitted to Department of Traumatic Surgery of Tongji Hospital from Janury 2019 to July 2020 were enrolled. Exclusion criteria included age<18 years old, length of hospital stay<15 days, previous medical history of malignancy, or immunological, consumptive, and metabolic diseases. According to the diagnostic criteria of PICS, all enrolled patients were divided into two groups: PICS group and N-PICS group (without PICS). The patient’s clinical characteristics, ISS score, GCS score, SOFA score, and prognosis were collected. The
χ2 test or Student’s
t test was uesd to compare the difference between the PICS group and N-PICS group.
Results:The incidence of PICS in patients with polytrauma was 11.7% (127/1 083). The majority of PICS patients were middle-aged and elderly men, 68.5% with traumatic brain injury and 59% with thoracic injury. GCS score was significantly lower, while ISS, APACHE II and SOFA scores were significantly higher in the PICS group than in the N-PICS group (
P<0.01,
P<0.05). Among PICS patients, 79.5% were treated with mechanical ventilation and 76.3% were associated with pulmonary infection, with a 28-day mortality of 5.5% and a 180-day mortality of 16.5%, which were siginifcantly different from those without PICS.
Conclusions:PICS has a high incidence after polytrauma and is commonly seen in middle-aged and elderly male patients with severe polytrauma, especially accompanied by traumatic brain injury or/and thoracic injury. Patients with PICS after polytrauma have poor long-term prognosis, so early identification and intervention should be strengthened in clinical practice. |
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Keywords: | Polytrauma Persistent inflammation-immunosuppression and catabolism syndrome Clinical characteristics Prognosis |
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