AECOPD伴严重呼吸衰竭患者有创机械通气疗效及相关影响因素分析  

Curative effect of invasive mechanical ventilation on AECOPD patients with severe respiratory failure and related factors analysis

作　　者：顾兰囡[1] 蔡海英[1] 任疆[1] 

机构地区：[1]浙江省绍兴市人民医院急诊科,312000

出　　处：《中华全科医学》2015年第5期750-752,共3页Chinese Journal of General Practice

摘　　要：目的探讨慢性阻塞性肺疾病急性加重(AECOPD)且伴有呼吸衰竭的患者有创通气治疗的效果,以及影响疗效的相关因素。方法选取绍兴市人民医院2012年1月—2014年5月收治的62例AECOPD伴严重呼吸衰竭患者进行研究,所有患者均采用有创机械通气治疗,观察患者的疗效,并对患者的临床资料进行单因素及多因素Logistic回归分析,分析影响疗效的相关因素。结果 35例成功撤机拔管,撤机成功率56.45%;14例撤机拔管失败,失败率为22.58%,其中9例再次气管插管接呼吸机辅助呼吸,5例行气管切开需长期机械通气;13例患者死亡,病死率20.97%。单因素分析结果显示年龄、入院时HGB,治疗后WBC、NEU%、CRP、HGB、ALB、MODS以及通气时间对AECOPD伴严重呼吸衰竭机械通气疗效的影响差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示年龄、入院时HGB、治疗后NEU%、ALB含量、机械通气时间为治疗失败的独立影响因素。结论机械通气是抢救、治疗AECOPD伴严重呼吸衰竭的有效且可靠的手段,能够延长患者生存期;积极处理可干预的独立危险因素是提高临床疗效、改善预后的关键。Objective To assess the curative effect of invasive mechanical ventilation therapy on AECOPD patients with severe respiratory failure and analyze the related factors. Methods 62 AECOPD patients with severe respiratory failure from January 2012 to April 2014 in our hospital were enrolled in this study. All patients were treated with invasive mechanical ventilation,the effects were observed after treatment,and the patient＇s clinical data were analyzed by using univariate and multivariate Logistic regression analysis to find the factors affecting efficacy. Results The extubation weaning was successfully performed in 35 cases with a success rate of 56. 45%,failed in 14 cases with a rate of 22. 58%,of which 9 cases were intubated again to pick ventilator-assisted breathing,5 underwent tracheotomy for long-term mechanical ventilation; 13 patients died with a mortality rate of 20. 97%. Univariate analysis showed that age,admission HGB,after treatment,WBC,NEU%,CRP,HGB,ALB,MODS and ventilation for AECOPD were statistically significant（ P〈0. 05）; multivariate Logistic regression analysis showed that age,admission HGB,NEU% after treatment,ALB content,duration of mechanical ventilation as independent factors for treatment failure. Conclusion Mechanical ventilation is an effective and reliable means for the rescuing and treatment of AECOPD patients with severe respiratory failure,it can prolong the survival time of patients. To deal actively with the independent risk factors can improve the clinical efficacy and improve the prognosis of patients.

关 键 词：AECOPD 呼吸衰竭 有创机械通气 影响因素 

分 类 号：R563[医药卫生—呼吸系统]