摘要
目的探讨剩余碱(BE)对重症急性胰腺炎(SAP)患者有创机械通气时机选择的价值。方法回顾性分析2016年6月~2019年6月江门市新会区人民医院、江门市人民医院收治的50例行有创机械通气治疗SAP患者临床资料,根据有创机械通气前BE值,分为A、B、C三组,其中C组BE≤-20mmol/L,B组-20mmol/L<BE≤-15mmol/L,A组BE>-15mmol/L,比较三组患者有创机械通气前及通气48h后的氧合指数(OI)、急性生理及慢性健康状况评分(APACHEⅡ评分)及病死率。结果机械通气48h后,B组患者的OI显著低于A组;C组患者的OI显著低于A、B组;C组APACHEⅡ评分显著高于A、B组,差异有统计学意义(P<0.05)。A组患者病死率显著低于C组,差异有统计学意义(P<0.05)。结论BE>-15mmol/L作为SAP有创机械通气指征,可有效提升SAP患者的OI,降低APACHEⅡ评分,降低病死率。
Objective To explore the value of base excess(BE)in timing selection of invasive mechanical ventilation in patients with severe acute pancreatitis(SAP).Methods The clinical data of 50 patients with SAP who underwent invasive mechanical ventilation treatment from June 2016 to June 2019 in Xinhui District People's Hospital of Jiangmen City and Jiangmen People's Hospital were retrospectively analyzed.They were divided into group A,B,and C based on the value of BE,of which group C:BE≤-20mmol/L,group B:-20mmol/L<BE≤-15mmol/L,group A:BE>-15mmol/L.The oxygenation index(OI),Acute Physiology and Chronic Health EvaluationⅡscore(APACHEⅡscore)and fatality rate before and 48 hours after invasive mechanical ventilation were compared between the two groups.Results After 48 hours of mechanical ventilation,the OI of group B was significantly lower than that of group A;the OI of group C was significantly lower than that of groups A and B;the APACHEⅡscore of group C was significantly higher than that of groups A and B,and the differences were statistically significant(P<0.05).The mortality rate of group A was significantly lower than that in group C,and the difference was statistically significant(P<0.05).Conclusion BE>-15mmol/L as an indicator of SAP invasive mechanical ventilation,can effectively improve the OI of SAP patients,reduce the APACHEⅡscore and the mortality.
作者
吴嘉锟
司徒双苗
姚慧文
张而立
WU Jiakun;SITU Shuangmiao;YAO Huiwen;ZHANG Er'li(Department of Intensive Medicine,Xinhui People's Hospital in Jiangmen,Guangdong,Jiangmen 529000,China;Department of Traditional Chinese Medicine,the People's Hospital of Jiangmen,Guangdong,Jiangmen 529100,China;Department of Critical Care Medicine,Taishan People's Hospital,Guangdong,Taishan 529200,China)
出处
《中国医药科学》
2020年第19期247-249,253,共4页
China Medicine And Pharmacy
基金
广东省江门市原卫生计生局科研立项项目(18A009)。
关键词
剩余碱
急性重症胰腺炎
有创机械通气
氧合指数
APACHEⅡ评分
病死率
Base excess
Severe acute pancreatitis
Invasive mechanical ventilation
Oxygenation index
Acute Physiology and Chronic Health EvaluationⅡscore
Fatality rate
