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目的研究探讨重症监护病房(ICU)患者中低磷血症的发生率及其对预后的影响,总结其临床经验和临床意义。方法选取我院2010年4月至2012年4月ICU中的患者46例,其中出现不同程度的低磷血症的患者34例,设为观察组,其余12例无出现低磷血症的患者,作为对照组,观察对比两组患者的预后差异。结果观察组患者呼吸机使用时间、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、平均住ICU时间、病死率方面与对照组相比皆存在显著差异(P<0.05);使用ROC曲线分析观察组中患者血磷水平与存活的敏感性、特异性及存活率间的关系,提示血磷水平越低,存活率越低,二者间有明显的正相关关系(r=0.34,P<0.05),而血磷水平在0.40mmol/L时,预测患者存活的敏感性、特异性最高。结论对ICU中的患者血磷水平进行监测,可及时发现其发生低磷血症,并可尽早预测患者的预后情况,具有重要的临床指导意义。
Objective To study the incidence of hypophosphatemia in intensive care unit (ICU) patients and its impact on prognosis and to summarize its clinical experience and clinical significance. Methods Forty-six patients with ICU were selected from April 2010 to April 2012 in our hospital. Among them, 34 patients with hypophosphatemia in different degrees were selected as the observation group and the remaining 12 patients without hypophosphatemia , As a control group, observed and compared two groups of patients with different prognosis. Results Compared with the control group, there were significant differences in the use of ventilator, APACHE Ⅱ score, mean ICU stay time and mortality in the observation group (P <0.05). The ROC curve analysis The relationship between serum phosphorus level and the survival sensitivity, specificity and survival rate in the observation group suggested that the lower the serum phosphorus level, the lower the survival rate. There was a significant positive correlation between them (r = 0.34, P < 0.05), while the serum phosphorus level at 0.40mmol / L, predict the survival of patients with the highest sensitivity and specificity. Conclusion It is of great clinical significance to monitor the level of phosphorus in patients with ICU in order to detect the occurrence of hypophosphatemia and to predict the prognosis of patients as soon as possible.