老年长期机械通气患者的预后影响因素  

Analysis of prognosis factors in elderly patients requiring long-term mechanical ventilation

作　　者：黄伟[1] 秦咏梅 万献尧[1] 张久之[1] 

机构地区：[1]大连医科大学第一临床学院中心ICU科,辽宁大连116011 [2]鞍钢矿山公司大连医院,辽宁大连116032

出　　处：《大连医科大学学报》2004年第3期197-199,共3页Journal of Dalian Medical University

摘　　要：[目的 ]探讨长期老年机械通气 (≥ 7d)患者的预后影响因素。 [方法 ]回顾性调查 2 0 0 1年 4月～ 2 0 0 3年 1 0月老年长期机械通气患者 ,对入院时生命体征、辅助检查以及急性生理与慢性健康评分 (APACHEⅡ )等指标进行调查 ,并对各项指标进行Logistic回归分析。 [结果 ]31例 (5 9.6 % )患者死亡 ,2 1例患者 (4 0 .4 % )生存。生存组的中心静脉压 (CVP)、白蛋白水平 (ALB)等理化指标以及APACHEⅡ评分显著优于死亡组 (P <0 .0 5 ) ,同时生存组中气管切开的比例较高 (P <0 .0 5 )。Logistic回归显示ALB (P =0 .0 1 ;OR值 0 .77;95 %可信区间 :0 .6 7～ 0 .87)对LTMV的预后有积极影响。 [结论 ]老年长期机械通气患者的院内死亡率较高 ,血清白蛋白水平和气管切开是主要的预后决定因素 。Objective] To investigate prognostic factors in elderly patients receiving long-term mechanical ventilation. [Methods] Retrospective study were made in 52 elderly patients receiving ≥7 days of mechanical ventilation from April 2001 to October 2003. Admitting clinical and physiological parameters were analyzed by Logistic regression methods. [Results] Of the patients enrolled in the study, 31 cases(59.6%)died in the hospital and 21 (40.4%)were survival. Differences in central venous pressure (CVP), level of plasma albumin and Acute Physiology and Chronic Health Evaluation (APACHE II) score between survivors and nonsurvivors were significant ( P <0.05). Performing tracheotomy were also significantly difference between two groups ( P <0.05). With multiple logistic regressions, higher ALB level ( P =0.01; OR 0.77; 95% confidence interval: 0.67～ 0.87) were independent predictors of benignantly outcome. [Conclusions] elderly LTMV patients should be considered in higher risk for death. Serum albumin level and undergoing tracheotomy were major prognosis factors; these relevant characteristics should be evaluated before mechanical ventilation.

关 键 词：机械通气 呼吸衰竭 预后 

分 类 号：R563.8[医药卫生—呼吸系统]