恶性机械性肠梗阻并发脓毒症的危险因素分析

刘杏; 张维; 马怀幸; 尉浩斌; 吴丹; 刘伟巍; 李世伟; 李苏宜

doi:10.16689/j.cnki.cn11-9349/r.2020.03.018

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肿瘤代谢与营养电子杂志 ›› 2020, Vol. 7 ›› Issue (3) : 347-351. DOI: 10.16689/j.cnki.cn11-9349/r.2020.03.018

论著

恶性机械性肠梗阻并发脓毒症的危险因素分析

刘杏1，张维 2，马怀幸1，尉浩斌1，吴丹1，刘伟巍1，李世伟1，李苏宜1

作者信息 +

Analysis of risk factors of sepsis in cancerous mechanical bowel obstruction

Liu Xing1, Zhang Wei2, Ma Huaixing1, Yu Haobin1, Wu Dan1, Liu Weiwei1, Li Shiwei1, Li Suyi1

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摘要

目的探讨恶性机械性肠梗阻并发脓毒症的危险因素。方法回顾性分析首发恶性机械性肠梗阻的245例患者的临床资料，采用非条件Logistic回归，多因素分析可能并发脓毒症的危险因素。结果恶性机械性肠梗阻并发脓毒症的发生率为11.8%（29/245）。单因素分析显示，并发脓毒症可能与患者的体质指数（BMI）<18.5kg/m2（P=0.033）、患者主观整体评估（PG-SGA）C级（P=0.026），和血清C反应蛋白、降钙素原、白介素-6等炎症因子血清水平升高（P<0.05）以及未联合糖皮质激素治疗（P=0.039）、腹盆腔放疗史（P=0.001）有关。多因素分析结果提示：BMI<18.5kg/m2、PG-SGA C级和血清C反应蛋白、降钙素原、白介素-6水平升高，以及未联合糖皮质激素治疗、腹盆腔放疗史是恶性机械性肠梗阻并发脓毒症的独立危险因素（P<0.05）。结论恶性机械性肠梗阻并发脓毒症系多种因素共同作用导致，其中以患者BMI<18.5kg/m2、PG-SGA C级和血清C反应蛋白、降钙素原、白介素-6水平升高，以及未联合糖皮质激素治疗、腹盆腔放疗史为主要危险因素。

Abstract

Objective To explore the risk factors of sepsis in cancerous mechanical bowel obstruction. Methods The clinical data of 245 patients with the first cancerous mechanical bowel obstruction were analyzed retrospectively. The possible risk factors of sepsis in these patients were analyzed by unconditional logistic regression. Results The incidence of cancerous mechanical intestinal obstruction complicated with sepsis was 11.8% (29/245). Single factor analysis suggests that concurrent sepsis may be related to the patients body mass index<18.5kg/m2(P=0.033), PG-SGA evaluation of C grade(P=0.026), and serum levels of inflammatory factors such as blood C-reactive protein, procalcitonin, interleukin-6 levels increased (P<0.05), and no glucocorticoid treatment(P=0.039), the history of abdominal and pelvic radiotherapy (P=0.001). The results of multivariate analysis showed that body mass index<18.5kg/m2, PG-SGA evaluation of C grade and serum C-reactive protein, procalcitonin, and interleukin-6 levels increased, as well as no glucocorticoid treatment and the history of abdominal pelvic radiotherapy are cancerous mechanical bowel independent risk factors for obstruction complicated with sepsis (P<0.05). Conclusion Cancerous mechanical bowel obstruction complicated with sepsis is caused by many factors, The main risk factors were patients with body mass index<18.5kg/m2, PG-SGA grade C, serum C-reactive protein, procalcitonin, interleukin-6 levels increased, glucocorticoid-free treatment and history of abdominal pelvic radiotherapy.

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刘杏，张维，马怀幸，尉浩斌，吴丹，刘伟巍，李世伟，李苏宜. 恶性机械性肠梗阻并发脓毒症的危险因素分析[J]. 肿瘤代谢与营养电子杂志. 2020, 7(3): 347-351 https://doi.org/10.16689/j.cnki.cn11-9349/r.2020.03.018

Liu Xing, Zhang Wei, Ma Huaixing, Yu Haobin, Wu Dan, Liu Weiwei, Li Shiwei, Li Suyi. Analysis of risk factors of sepsis in cancerous mechanical bowel obstruction[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2020, 7(3): 347-351 https://doi.org/10.16689/j.cnki.cn11-9349/r.2020.03.018

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