摘要
目的:探讨严重创伤患者发生急性呼吸窘迫综合征(ARDS)的危险因素。方法:回顾性分析2018年5月至2020年5月该院收治的64例严重创伤患者的临床资料。对可能导致严重创伤患者发生ARDS的相关因素进行单因素、多因素分析。结果:64例严重创伤患者中,发生ARDS 15例,发生率23.44%(15/64);患者年龄、性别、受伤原因、是否合并心房颤动、是否伴有休克、出血量及血清白蛋白水平与ARDS的发生无关(P>0.05);创伤部位、氧合指数(OI)、血管外肺水指数(EVLWI)、空腹血糖(FBG)水平、急性生理学和慢性健康状况评分系统Ⅱ(APACHEⅡ)与患者发生ARDS有关(P<0.05);肺部创伤、OI<300 mmHg(1 mmHg=0.133 kPa)、EVLWI≥7.0 mL/kg、FBG水平≥7.0 mmol/L、APACHEⅡ评分≥15分是严重创伤患者发生ARDS的独立危险因素(OR>1,P<0.05)。结论:肺部创伤、OI<300 mmHg、EVLWI≥7.0 mL/kg、FBG水平≥7.0 mmol/L、APACHEⅡ评分≥15分是严重创伤患者发生ARDS的独立危险因素,临床应对合并这些因素的患者给予针对性干预,以预防ARDS的发生。
Objective:To investigate risk factors of acute respiratory distress syndrome(ARDS)in patients with severe trauma.Methods:The clinical data of 64 patients with severe trauma admitted to the hospital from May 2018 to May 2020 were retrospectively analyzed.Then,the univariate analysis and the multivariate analysis were used to analyze the risk factors of ARDS among these patients.Results:Among the 64 severe trauma patients,15 cases had ARDS,with an incidence rate of 23.44%(15/64).The patients’age,gender,cause of injury,atrial fibrillation,shock,blood loss,and serum albumin levels were not significantly correlated with the occurrence of ARDS(P>0.05).The trauma site,oxygenation index(OI),extravascular lung water index(EVLWI),fasting blood glucose(FBG)level,acute physiology and chronic health evaluationⅡ(APACHEⅡ)were significantly correlated with the occurrence of ARDS(P<0.05).Lung trauma,OI<300 mmHg(1 mmHg=0.133 kPa),EVLWI≥7.0 mL/kg,FBG≥7.0 mmol/L,and APACHE II score≥15 are the independent risk factors of ARDS in the severe trauma patients(OR>1,P<0.05).Conclusions:The lung trauma,OI<300 mmHg,EVLWI≥7.0 mL/kg,FBG≥7.0 mmol/L,and APACHEⅡscore≥15 are the independent risk factors of ARDS in the severe trauma patients.Clinically,it should give the targeted intervention to the patients with these factors to prevent the occurrence of ARDS.
作者
马晖峰
MA Huifeng(Surgery Department of Pingdingshan the Second People’s Hospital,Pingdingshan 467000 Henan,China)
出处
《中国民康医学》
2021年第16期95-97,共3页
Medical Journal of Chinese People’s Health
关键词
严重创伤
急性呼吸窘迫综合征
氧合指数
血管外肺水指数
血糖
Severe trauma
Acute respiratory distress syndrome
Oxygenation index
Extravascular lung water index
Blood glucose
