危重病患者气管插管后低血压高危因素及预后研究  

The Risk Factors and Prognosis of Postintubation Hypotension in Critically Ill Patients

作　　者：王蔚[1,2] 周愚[1,3] 苏真娇[1,2] 郑伟[1,2] 赵灵[1,2] 

机构地区：[1]暨南大学附属珠海医院 [2]珠海市人民医院重症医学科,广东珠海519000 [3]珠海市人民医院麻醉科,广东珠海519000

出　　处：《中国呼吸与危重监护杂志》2015年第5期474-476,共3页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的研究重症患者气管插管后低血压发生情况、危险因素及预后,为进一步治疗提供依据。方法收集重症医学科内近2年气管插管前血压正常患者的临床资料进行分析,分为插管后低血压组和插管后正常血压组,主要预后指标为28 d病死率,次要预后指标为ICU住院天数和总住院日。结果 79例患者纳入分析,其中25例（31.65%）气管插管后出现低血压情况,低血压组28 d死亡率较血压正常组明显增高（40.00%比14.81%,P=0.01）,ICU住院天数和总住院日则未见差异。高龄（OR：1.1,95%CI：1.00~1.12）、慢性呼吸系统疾病（OR：3.0,95%CI：1.13~8.07）及合并两种以上慢性病（OR：3.6,95%CI：1.18~11.03）为高危因素。结论重症患者气管插管后发生低血压事件更多见于老年合并多种慢性病患者,插管后发生低血压增加患者28 d死亡风险。Objective To identify the incidence of postintubation hypotension（ PIH） in critically ill patients and evaluate the responsive risk factors and prognosis.Methods The data of intubation patients with normal blood pressure before intubation were collected and analyzed in Intensive Care Unit（ ICU） in the latest two years and divided into two groups.One contained PIH patients and the other one contained patients with no change in blood pressure after intubation.The primary outcome measure was 28-day mortality and secondary outcome measure was length of stay（ LOS） in ICU and hospital.Results There were 25（ 31.65%） PIH patients in included 79 patients.The patients in PIH group had significantly higher28-day mortality（ 40.00% vs 14.81%,P = 0.01） and there were no difference in LOS in ICU and hospital.Risk factors were age（ OR：1.1,95% CI：1.00-1.12）,chronic respiratory diseases（ OR：3.0,95% CI：1.13-8.07） and complication with over two chronic diseases（ OR：3.6,95% CI：1.18-11.03）.Conclusion PIH is more common in old patients complicated with chronic diseases and results in higher 28-day mortality.

关 键 词：气管插管 低血压 重症加强治疗病房 

分 类 号：R614[医药卫生—麻醉学]