Risk Factors Of Multiple Injuries Patients Combined With Stress Ulcer Bleeding

Objective:The purpose of theresearchis to investigate the clinical characteristics and risk factors of multiple injuries patients combined with Stress Ulcer Bleeding(SUB)in our hospital,so as to provide theoretical basis for effective prevention and individualized treatment of patients with multiple trauma.Methods:Through collecting clinical case data of patients with multiple injuries in Emergency Intensive Care Unit(EICU)and the department of Intensive Care Unit of our hospital from September,2018 to December,2019,the patients were divided into bleeding group and non-bleeding group based on whetehr it is combined with ulcer bleeding or not.After analyzing of incidence,death rate and related risk factors of stress ulcer hemorrhage,the diagnosis of SUB is comprehensively confirmed in accordance with relevant literature.a record of risk factors related to injuries combined with stress ulcer was prepared,the author could analyze possible risk factors of multiple injuries patients combined with Stress Ulcer Bleeding,and to observe the incidence,time and clinical manifestations of SUB.Results:1.A total of 237 patients with multiple injuries were collected,including 46 patients with Stress Ulcer Bleeding,with an ulcer incidence of 19.4%(46/237).There were 3 cases of massive alimentary tract bleeding,including 2 death cases,8 cases of brown blood or fresh blood drained from gastric tube,and 7 cases of hematochezia and melena.The remaining 28 cases only showed fecal occult blood or positive occult blood in gastric juice.2.In univariate analysis,there were statistically significant differences between the two groups in the incidence of ulcer bleeding and the intervention measures such as mechanical ventilation,sedative drugs,surgery,prophylactic use of PPI and early enteral nutrition.3.The results of univariate analysis showed relevant factors of patients with multiple injuries combined the related factors of Stress Ulcer Bleeding are APACHEII score,ISS score,injured parts(head,chest),white blood cell count,platelet count,prothrombin time,activated prothrombin time,blood glucose,albumin,aspertate aminotransferase,blood sedimentation,c-reactive protein,lactic acid value.4.Patients with multiple injuries combined with bleeding group had a longer hospital stay compared with the non-bleeding group,and it make a statistical difference(P<0.05).5.Multivariate logistic regression analysis proved that the independent risk factors for occurrence of stress ulcer bleeding are APACHEIIscore,ISS score,head injury,mechanical ventilation,and decreased platelet count?Conclusion:1.Patients with multiple injuries suffering from Stress Ulcer Bleeding occurs is in higher incidence,poor prognosis,and a prolonged hospital stay,therefore,patients with severe multiple injuries should be alert to the occurrence of ulcer bleeding.2.Elevated stress white blood cells,stress hyperglycemia,abnormal coagulation function,increased c-reactive protein,and increased blood sedimentation can be deemed as predictors of Stress Ulcer Bleeding,thus it provides references of preventive medication for clinicians.3.The independent risk factors for Stress Ulcer Bleeding are APACHEII score,ISS score,head injured,mechanical ventilation,and decreased platelet count.