重症脑梗死机械通气患者死亡因素分析  

Factors for mortality in acute ischemic stroke patients on mechanical ventilation

作　　者：罗小娜[1] 冯丽君[1] 陈江波[1] 常景环[1] 杨全玉[1] 

机构地区：[1]河南大学附属郑州市第一人民医院神经内科,450004

出　　处：《中华老年心脑血管病杂志》2015年第10期1076-1078,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨重症脑梗死机械通气死亡相关因素,寻找对重症脑梗死机械通气患者死亡有预测价值的指标。方法回顾性分析脑梗死机械通气患者102例,根据是否院内死亡分为生存组63例和死亡组39例,比较2组基本资料、检查结果及撤机相关因素。结果死亡组年龄≥75岁(66.7%vs 39.7%)、冠心病(61.5%vs 31.7%)、低蛋白血症(66.7%vs 23.8%)、肾功能不全(59.0%vs 36.5%)、电解质紊乱(61.5%vs 30.2%)、机械通气时间[(181.85±146.41)h vs(118.20±109.41)h]、呼吸机相关性肺炎(59.0%vs 33.3%)明显高于生存组,撤机成功(17.9%vs 81.0%)明显低于生存组,差异有统计学意义(P<0.05,P<0.01)。多因素logistic回归分析显示,年龄≥75岁(OR=9.671,P=0.003)、撤机成功(OR=0.038,P=0.000)与重症脑梗死机械通气患者死亡明显相关。结论年龄≥75岁及撤机失败的重症脑梗死患者死亡风险明显增加。Objective To study the factors for mortality in acute ischemic stroke（AIS）patients on mechanical ventilation.Methods One hundred and two AIS patients on mechanical ventilation were divided into survival group（n=63）and death group（n=39）.Their general data,laboratory data,and ventilator weaning-related factors were retrospectively analyzed.Results The mortality of age≥75years,CHD,hypoproteinemia,renal insufficiency,electrolyte disturbance,and the mechanic ventilation time ventilator-associated pneumonia was significantly higher,and the successful ventilator weaning rate was significantly lower in death group than in survival group（66.7%vs 39.7%,61.5% vs 31.7%,66.7% vs 23.8%,59.0% vs 36.5%,61.5% vs 30.2%,59.0%vs 33.3%,181.85±146.41 hvs 118.20±109.41 h,17.9% vs 81.0%,P〈0.05,P〈0.01）.Multivariate logistic regression analysis showed that age≥75years and successful ventilator weaning were closely related with the mortality of AIS patients on mechanical ventilation（OR=9.671,P=0.003;OR=0.038,P=0.000）.Conclusion The mortality of AIS patients increases with the age≥75years and ventilator weaning failure.

关 键 词：脑梗死 呼吸 人工 通气机 机械 死亡原因 冠心病 低蛋白血症 水电解质失调 肾功能不全 肺炎 呼吸机相关性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]