慢性支气管炎住院患者机械通气的危险因素分析  

Risk Factors of Mechanical Ventilation in in-patients with Chronic Bronchitis

作　　者：李曾[1,2] 许义新[3] 邓常文[4] 张星星[4] 朱天怡[1] 

机构地区：[1]沈阳军区总医院呼吸科,辽宁沈阳110016 [2]南京医科大学附属第一医院骨科,江苏南京210029 [3]上海长征医院神经内科,上海200003 [4]上海长海医院呼吸内科,上海200433

出　　处：《现代生物医学进展》2015年第36期7081-7084,7062,共5页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81270073)

摘　　要：目的:分析慢性支气管炎住院患者进行辅助机械通气的危险因素。方法:采取回顾性统计分析方法,收集2009-2014年5年中共1746例慢性支气管炎住院患者的临床资料,应用SPSS 17软件分组对年龄、性别、肺气肿、慢性肺源性心脏病、肺性脑病、肺大泡、肺炎、支气管扩张、哮喘、冠心病、高血压病、糖尿病、低蛋白血症、贫血、肝功能异常、肾功能异常等因素进行卡方检验及危险因素分析。结果:1746慢性支气管炎患者中,进行辅助机械通气治疗者626人(无创辅助通气613人、有创辅助通气187人),未进行辅助机械通气治疗者1120人。辅助机械通气治疗者中有439人单纯行无创辅助通气、13人单纯行有创辅助通气、174人为两种通气方式序贯。统计分析显示:高龄(>65岁)、慢性肺气肿、慢性肺源性心脏病、肺性脑病、糖尿病、低蛋白血症、肝功能异常、肾功能异常是慢性支气管炎患者行无创辅助通气的危险因素(OR>1,P<0.05);高龄(>65岁)、男性、慢性肺源性心脏病、肺性脑病、肺炎、糖尿病、低蛋白血症、贫血、肝功能异常、肾功能异常是慢性支气管炎患者行有创辅助通气的危险因素(OR>1,P<0.05)。结论:高龄、性别以及一些肺内外合并疾病是慢性支气管炎住院患者行辅助通气的危险因素,提示在临床工作中对这一类患者加强教育、积极控制合并症具有重要的意义。Objective： To determine the risk factors for invasive or noninvasive mechanical ventilation in in-patients with chronic bronchitis. Methods： This retrospective study included 1746 patients with chronic bronchitis from 2009 to 2014. The patients were divided into three groups： invasive mechanical ventilation, noninvasive mechanical ventilation and no mechanical ventilation. Chi-square tests and OR values were used to identify the characteristics（age, sex） or comorbidities as risk factors relating to patients＇ dependency on mechanical ventilation by SPSS 17 software. Results： Among the 1746 patients, 626 were taken mechanical ventilation（613 for noninvasive and 187 for invasive） and 1120 were taken no mechanical ventilation. In patients with mechanical ventilation, 439 were taken only noninvasive mechanical ventilation, 13 were taken only invasive ones while 174 were taken both. The statistical analysis presented that aged, patients with pulmonary emphysema, chronic cor pulmonale, pulmonary encephalopathy, diabetes, hypoproteinemia,hypohepatia and renal insufficiency were the risk factors of noninvasive mechanical ventilation（OR1,P〈0.05） while aged, male, patients with chronic cor pulmonale, pulmonary encephalopathy, pneumonia, diabetes, hypoproteinemia, anemia, hypohepatia and renal insufficiency were the risk factors of invasive mechanical ventilation（OR1,P〈0.05）. Conclusions： Age65 years, sex and some comorbidities are the risk factors of mechanical ventilation in in-patients with chronic bronchitis. In clinic, more communications with such patients and positive treatments for their comorbidities would contribute to decrease the rate of using mechanical ventilation.

关 键 词：慢性支气管炎 机械通气 危险因素 

分 类 号：R562.21[医药卫生—呼吸系统]