摘要
目的:研究重症医学科机械通气治疗慢性阻塞性肺疾病急性加重(AECOPD)合并Ⅱ型呼衰患者的二次插管的影响因素,分析二次插管的独立危险因素。方法:采用回顾性病例对照研究,选取我科2016年6月-2017年6月收治的使用机械通气治疗AECOPD合并Ⅱ型呼衰患者为研究对象。收集患者的各项资料和化验指标,采用t检验及χ2检验进行组间比较,采用单因素回归方法分析二次插管的影响因素;采用多因素Logistic回归方法,分析二次插管的独立危险因素。结果:单因素Logistic回归分析结果显示,年龄、拔管前白蛋白、拔管前血红蛋白、日常生活自理能力、营养状态、APACHEⅡ评分、咳痰能力、机械通气时间、痰液的量、住ICU时间,为患者二次插管的影响因素,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示拔管前白蛋白,拔管前血红蛋白为影响机械通气治疗AECOPD合并Ⅱ型呼衰患者二次插管的独立危险因素,差异有统计学意义(P<0.05)。结论:机械通气治疗AECOPD合并Ⅱ型呼衰患者,拔管前白蛋白和血红蛋白,是影响患者二次插管的独立危险因素。
Objective:To analyze the influencing factors of secondary intubation in patients with AECOPD combined with typeⅡrespiratory failure treated by mechanical ventilationin intensive care unit,and to determine the independent risk factors of secondary intubation.Methods:From June 2016 to June 2017 in the intensive care department,a retrospective case-control study was carried out to analyze the medical records of patients with AECOPD complicated with typeⅡrespiratory failure.Social demographic data and blood test indexes were collected.T test or chi-square test was used to compare the data between the groups,and univariate Logistic regression analysis was conducted to analyze the influencing factors of secondary intubation.Then,Multivariate Logistic regression was used to analyze the independent risk factors of secondary intubation.Results:Single factor logistic regression analysis results showed that age,daily life self-care ability,albumin before extubation,hemoglobin before extubation,duration of mechanical ventilation,duration of stayed in ICU,APACHEⅡscore,expectoration capacity,the quantity of sputum,nutrition condition assessment,to influence patients with AECOPD combined with typeⅡrespiratory failure treated by mechanical ventilation,the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that the albumin before extubation,hemoglobin before extubation were independent risk factors for secondary intubation in patients with mechanical ventilation,and the difference was statistically significant(P<0.05).Conclusion:Mechanicalventilation in the treatment of patients with AECOPD combined withtypeⅡrespiratory failure,albumin and hemoglobin before extubation are independent risk factors influencing patients with secondary intubation.
作者
冯丽伟
赵岳
王斌
李真玉
何新飙
FENG Li-wei;ZHAO Yue;WANG Bin;LI Zhen-yu;HE Xin-biao(School of Nursing,Tianjin Medical University,Tianjin 300070,China;Department of Critical Care Medicine,The Second Hospital,Tianjin Medical University,Tianjin 300211,China)
出处
《天津医科大学学报》
2020年第1期22-27,共6页
Journal of Tianjin Medical University
关键词
机械通气
AECOPD合并Ⅱ型呼衰
二次插管
影响因素
mechanicalventilation
AECOPD combined with typeⅡrespiratory failure
secondary intubation
influencing factors
