摘要
目的分析APACHE-Ⅱ、PCT、ALB、CRP对慢性阻塞性肺疾病机械通气患者脱机、预后的影响。方法根据2018年GOLD指南将在我院RICU、ICU中进行有创机械通气的COPD患者在进行有创机械通气前行APACHE-Ⅱ评分、PCT、CRP等测定同时记录患者一般情况,包括性别、年龄等相关资料,对成功脱机组、呼吸机依赖组、死亡组的患者相关因素进行比较,分析其有无差异。结果共纳入152例患者,死亡组28例、脱机困难组49例及成功脱机组75例,三组的APACHE-Ⅱ评分无显著性差异。与成功脱机组相比,死亡组与脱机困难组ALB显著降低,差异有统计学意义(P<0.05)死亡组与脱机困难组PCT显著升高差异有统计学意义(P<0.05)。与死亡组相比,成功脱机组CRP显著降低差异有统计学意义(P<0.05);脱机困难组CRP有降低的趋势但差异无统计学意义(P>0.05)。与成功脱机组相比死亡组CRP显著升高差异有统计学意义(P<0.05);脱机困难组CRP有升高的趋势,但差异无统计学意义(P>0.05)。结论APACHE-Ⅱ评分在死亡组、脱机困难组及成功脱机组无显著差异,PCT、ALB、CRP对慢性阻塞性肺疾病机械通气患者的脱机及预后有一定的预测作用。
Objective To analysis the effects of APACHE-Ⅱ,PCT,ALB and CRP on the weaning and prognosis of COPD patients with mechanical ventilation.Methods According to the GOLD guideline 2018,APACHE-Ⅱ scores,PCT and CRP were measured before invasive mechanical ventilation in the COPD patients received invasive mechanical ventilation in the RICU and ICU in our hospital.Meanwhile,the general characteristics,including sex,age,etc.were recorded.The factors related to the successful-to-wean group,the difficult-to-wean group and the death group were compared to analyze the statistical differences.Results A total of 152 patients were included 28 cases in the death group,49 cases in the difficult-to-wean group and 75 cases in the successful-to-wean group.The APACHE4 I scores among the three groups showed no significant differences.Compared to the successful-to-wean group,LAB in the difficult-to-wean group significantly reduced(P<0.05) PCT in the death group and the difficult-to-wean group increased significantly(P<0.05).Compared to the death group the successful-to-wean group showed significant decrease in CRP(P<0.05),the difficult-to-wean group also showed a trend in the decrease of CRP,but not significant(P>0.05).Compared to the successful-to-wean group,the CPR level increased significantly in the death group and also showed an increase trend in the difficult-to-wean group,but not significant.Conclusion APACHE4 I scores showed no significant differences in the death group the difficult-to-wean group and the successful-to-wean group.PCT,ALB and CRP can predict weaning and prognosis of COPD patients with mechanical ventilation.
作者
陈庆
吴亚
蒋才玉
刘跃建
滕鸿
Chen Qing;Wu Ya;Jiang Caiyu(Department of Respiratory and Critical Diseases,Department of Infection,Sichuan Academy of Medical Sciences,Sichuan People's Hospital,Chengdu,Sichuan 610072,China)
出处
《四川医学》
CAS
2020年第1期29-32,共4页
Sichuan Medical Journal
基金
四川省卫生与计划生育委员会科研基金资助项目(编号:16PJ414)
关键词
慢性阻塞性肺疾病
机械通气
预后
chronic obstructive pulmonary disease
mechanical ventilation
prognosis
