AECOPD并机械通气患者一年内死亡风险及其影响因素  

One year death risk and influencing factors of survival time in patients with AECOPD treated with mechanical ventilation

作　　者：姚建华[1] 汪正光[1] 程金霞[1] 郑绍鹏[1] 张牧城[1] 

机构地区：[1]皖南医学院附属黄山市人民医院重症医学科,245000

出　　处：《实用医学杂志》2012年第24期4124-4126,共3页The Journal of Practical Medicine

摘　　要：目的:通过对慢性阻塞性肺疾病急性加重期(AECOPD)出现呼吸衰竭并机械通气患者的随访观察,分析患者在一年内的死亡风险及其危险因素。方法:前瞻性收集我科2009年6月至2011年7月收治的COPD急性加重期出现呼吸衰竭并机械通气患者的临床资料,以入住ICU时作为观察起点,以患者死亡或入住ICU后365d为观察终点,收集相关资料并进行统计分析。结果:61例患者被纳入本研究,死亡39例,存活22例,死亡率为63.94%。平均生存时间179d,SE20d,中位生存时间124d,SE64d。死亡组平均年龄(71.09±9.21)岁,死于COPD急性加重28例(71.79%),脑血管意外3例(7.69%),肺炎3例(7.69%),心血管事件3例(7.69%),其他2例(5.13%)。Cox回归分析结果表明慢性阻塞性肺疾病和支气管哮喘预后评分是患者死亡的独立危险因素(P=0.001)。结论:COPD急性加重期出现呼吸衰竭并机械通气患者1年内死亡风险极高,主要死亡原因是COPD急性加重,COPD和支气管哮喘预后评分是死亡的独立危险因子。Objective To study one year death risk and influencing factors of survival time in patients with AECOPD complicated by type U respiratory failure and combined with mechanical ventilation. Methods From June 2009 to July 2011, and all patients with AECOPD complicated by type I1 respiratory failure and combined with mechanical ventilation were included prospectively. Patients were observed as soon as ICU admission and followed up for 365 days. The data of all patients were collected and clinical data were analysised.And Cox regression analysis was used to select the independent risk factors of influencing the survival time. Results A tatol of the 61 patients enrolled, 22 were survived and 39 were died, the mean survival time was 179 d （SE 20 d）, the median survival time was 124 d （SE 24 d）. The mortality was 63.94%. The causes of death in patients were as follows： AECOPD （71.79%）, cerebrovascular diseases （7.69%）, cardiovascular diseases （7.69%）, pneumonia （7.69%）, others（5.13%）. The independent risk factor was the COPD and Asthma Prognostic Score. Conclusions The patients with AECOPD combined with mechanical ventilation have high death risk, the independent risk factor is the COPD and Asthma Prognostic Score.

关 键 词：慢性阻塞性肺疾病 死亡风险 支气管哮喘 预后 

分 类 号：R563.9[医药卫生—呼吸系统]