钠离子紊乱对机械通气患者近期预后的预测价值  

Impact of dysnatremias on prognosis of ventilation patients

作　　者：刘平[1] 臧学峰[1] 甄洁[1] 朱曦[2] 陈炜[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院重症医学科,北京100038 [2]北京大学第三医院重症医学科

出　　处：《中华保健医学杂志》2017年第3期213-215,共3页Chinese Journal of Health Care and Medicine

基　　金：国家自然科学基金面上项目(81372043)

摘　　要：目的分析血清钠离子对机械通气患者14及30 d预后的预测价值。方法连续入选2015年1月~2016年8月在本院ICU住院行气管插管机械通气的患者247例,回顾性总结患者的电解质水平、APACHE II评分、肝肾功能、炎症指标、14及30 d预后结果等,分析电解质尤其是钠离子对14及30 d预后的影响,以及影响钠离子的因素。结果 COX单因素及多因素分析显示,高钠血症是14及30 d预后不佳的危险因素,钠离子水平对机械通气时间没有影响。钠离子紊乱发生率较高,低钠血症为24.7%,高钠血症为23.9%。APACHEII评分、肾功能及甲状腺功能与钠离子水平呈显著相关。结论对于机械通气患者,血钠≥145 mmol/L是14及30 d预后不佳的独立预测因素。Objective To analyze the basic sodium level on prognosis of ventilation patients. Methods A total of 247 consecutive patients who received incubation in the ICU in our hospital from Jan 2015 to Aug 2016 were retrospectively studied. We summarized the results of electrolytic level,APACHE II score,liver and kidney function,inflammation index,14 day and 30 day prognosis. The impact of electrolytic levels on prognosis was analyzed ,especially sodium level. We also analyzed the influencing factors of sodium. Results 247 patients with ventilation,according to single factor and multiple factors COX regression analyses, hypernatremia was risk factor of poor 14 day and 30 day prognosis. However ,sodium level had on influence on ventilation duration. Dysnatremias had a high morbidity. The proportion of hyponatremia was 24.7%,while the hypernatrmia was 23.9%. APACHE II score,renal function and thyroid hormones were significantly correlated with sodium. Conclusion Hypernatremia is the independent risk factor for poor prognosis in ventilation patients in ICU.

关 键 词：机械通气 钠离子 预后 

分 类 号：R589.4[医药卫生—内分泌]