住院哮喘患者行机械通气治疗情况分析  

Analysis of inpatients with asthma received mechanical ventilation

作　　者：谢华[1] 张志远[1] 张俊丽[1] 刘美岑[1] 宋迪[1] 赵海涛[1] 马壮[1] 陈萍[1] 

机构地区：[1]沈阳军区总医院呼吸和变态反应疾病诊治中心,沈阳辽宁110016

出　　处：《临床肺科杂志》2015年第10期1805-1807,共3页Journal of Clinical Pulmonary Medicine

基　　金：辽宁省自然科学基金(No 201202244)

摘　　要：目的分析住院哮喘患者行机械通气治疗情况。方法采取回顾性方法，收集6年内住院哮喘患者中行机械通气治疗的患者年龄、性别、所患疾病种类和住院费用等临床资料，分别进行统计和分类汇总。结果2009～2014年共有1327哮喘患者住院治疗，行机械通气的患者占6．6％，其中行无创机械通气治疗占3．4％，有创机械通气占3．2％。行机械通气治疗哮喘患者倾向于高龄、入住ICU，出现Ⅱ型呼吸衰竭。有创机械通气治疗组与无创治疗组和非机械通气组比较，肺炎、糖尿病、脑血管病和。肾功能不全等伴发疾病多。无创机械通气治疗组患者，男性多，合并支气管扩张多，冠心病、肝功能不全等合并症与非机械通气组相似。进一步进行危险因素分析，发现无创机械通气危险因素较少，只有年龄大于65岁、男性、入住ICU、出现Ⅱ型呼吸衰竭和合并支气管扩张；有创机械通气的危险因素较多，为年龄大于65岁、入住ICU、出现Ⅱ型呼吸衰竭、合并肺炎、冠心病、糖尿病、脑血管疾病和肝、肾功能不全。非机械通气哮喘住院患者住院人均费用为11667元，而机械通气治疗的住院哮喘患者人均费用42460元，与非机械通气患者比较，差异有显著性统计学意义（P〈0．05）。住院非机械通气哮喘患者死亡率为0．20％，无创通气治疗组死亡率为2．2％，有创通气治疗组死亡率为27．9％，各组间差异有显著统计学意义（P〈0．05）。结论高龄和合并症是导致患者行机械通气治疗的主要原因。Objective To analyze the curative effect of mechanical ventilation in the treatment of inpatients with asthma. Methods The clinical data of inpatients with asthma received mechanical ventilation during recent 6 years were retrospectively analyzed, including age, sex, type of illness and hospitalization costs. Results there were a total of 1327 cases of asthmatic patients from 2009 to 2014, and 6.6% of them were given mechanical ventilation, including 3.4% of non-invasive mechanical ventilation and 3.2% of invasive mechanical ventilation. Those patients received mechanical ventilation were tend to be senior citizens, staying in ICU and complicating with type ]/ respira- tory failure. The incidence of pneumonia, diabetes, cerebrovascular disease and renal failure was higher in the venti- lation group than in the control group. The non-invasive mechanical ventilation group had the characteristics of more male and bronchieetasis. Further analysis of the risk factors found that the risk factors of non-invasive mechanical ventilation only included older than 65 years, male, stay in ICU, type ]1 respiratory failure and bronchiectasis, but the risk factors of invasive mechanical ventilation included older than 65 years, stay in ICU, type 1I respiratory fail- ure, pneumonia, coronary heart disease, diabetes, cerebrovaseular disease, and liver and kidney dysfunction. The average hospitalization cost was 11,667 yuan for non-ventilation patients, and 42,460 yuan for ventilation patients （ P 〈 0. 05 ）. The mortality of the non-ventilation group was 0. 2% , 2. 2% of the non-invasive ventilation group, and 27. 9% of the invasive ventilation group （ P 〈 O. 05 ）. Conclusion The main risk factors causing asthma inpatients received mechanical ventilation are old age and complications.

关 键 词：创机械通气 哮喘 共存病 

分 类 号：R562.25[医药卫生—呼吸系统]