有创机械通气患者发生肺不张的危险因素分析  

Risk factors associated with the complication of atelectasis in patients with invasive mechanical ventilation

作　　者：陈治国[1] 檀立端[1] CHEN Zhiguo;TAN Liduan(Department of Emergency,Chengde Central Hosptial,Chengde,067000,Hebei,China)

机构地区：[1]承德市中心医院急诊科,河北承德067000

出　　处：《临床急诊杂志》2018年第10期677-680,共4页Journal of Clinical Emergency

摘　　要：目的:探讨有创机械通气患者发生肺不张的相关因素,为有创机械通气患者发生肺不张的预防策略提供依据。方法:96例有创机械通气患者机械通气后经胸部CT检查确诊肺不张患者33例,按结果分为肺不张组(33例)和非肺不张组(63例),对两组患者的性别、年龄、机械通气原因、通气时间、镇静程度、吸氧浓度、机械通气模式、吸痰频次、潮气量和平台压进行χ~2检验和多因素Logistic回归分析。结果:肺不张组与非肺不张组患者的机械通气原因(χ~2=6.583,P=0.010)、机械通气时间(χ~2=6.310,P=0.012)、镇静程度(χ~2=9.393,P=0.009)、吸氧浓度(χ~2=7.003,P=0.008)、通气模式(χ~2=5.595,P=0.018)、吸痰频次(χ~2=4.269,P=0.039)、潮气量(χ~2=4.979,P=0.026)和平台压(χ~2=6.853,P=0.032)比较差异均有统计学意义(P<0.05),而两组患者性别(χ~2=0.582,P=0.446)和年龄(χ~2=1.494,P=0.222)比较差异无统计学意义。多因素Logistic回归分析显示,镇静程度(OR=7.343,95%CI:1.701~31.694,P=0.008)、机械通气原因(OR=4.753,95%CI:1.322~16.952,P=0.016)、吸痰频次(OR=4.586,95%CI:1.243~16.925,P=0.022)、潮气量(OR=6.505,95%CI:1.820~23.257,P=0.004)和平台压(OR=4.999,95%CI:2.045~12.223,P<0.001)均为导致机械通气患者发生肺不张的独立危险因素。结论:镇静程度、机械通气原因、吸痰频次、潮气量和平台压是有创机械通气患者发生肺不张的独立危险因素。Objective：To explore the risk factors associated with the complication of atelectasis in patients with invasive mechanical ventilation.To provide the basis for making the early prevention strategy of the complication of atelectasis in patients with invasive mechanical ventilation.Method：A total of 96 patients with invasive mechanical ventilation in the department of emergency of were selected.Thirty-three patients were diagnosed atelectasis by the chest CT.The patients were divided into two groups by the chest CT result.The atelectasis group had 33 patients and the non-atelectasis group had 63 patients.χ~2 test and multiple factors Logistic regression was used to analyze the influencing factors of the complication of atelectasis in patients with invasive mechanical ventilation（Sex,age,reasons of mechanical ventilation,mechanical ventilation time,sedation degree,concentration of oxygen inhalation,ventilation mode,sputum absorption frequency,tidal volume and plateau pressure）.Result：The reasons of mechanical ventilation（χ~2=6.583,P=0.010）,mechanical ventilation time（χ~2=6.310,P=0.012）,sedation degree（χ~2=9.393,P=0.009）,concentration of oxygen inhalation（χ~2=7.003,P=0.008）,ventilation mode（χ~2=5.595,P=0.018）,sputum absorption frequency（χ~2=4.269,P=0.039）,tidal volume（χ~2=4.979,P=0.026）and plateau pressure（χ~2=6.853,P=0.032）between the two groups were significantly different（P〈0.05）.There was no significant difference in sex and age between the two groups（χ~2=0.582,P=0.446;χ~2=1.494,0.222）.Multivariate logistic regression analysis showed that sedation degree（OR=7.343,95%CI：1.701~31.694,P=0.008）,reasons of mechanical ventilation（OR=4.753,95%CI：1.322~16.952,P=0.016）,sputum absorption frequency（OR=4.586,95%CI：1.243~16.925,P =0.022）,tidal volume（OR=6.505,95%CI：1.820~23.257,P =0.004）and plateau pressure（OR=4.999,95%CI：2.045~12.223,P0.001）were independent risk factors of the complication of atelectasis in patients with invasive mec

关 键 词：有创机械通气 肺不张 危险因素 

分 类 号：R563.4[医药卫生—呼吸系统]