急性呼吸衰竭患者无创通气治疗失败的影响因素分析  

Influencing factors of failure of noninvasive ventilation in the treatment of acute respiratory failure

作　　者：任红岩[1] 王月霞[1] 忽新刚[1] 潘金兵[1] 张晓菊[1] Ren Hongyan;Wang Yuexia;Hu Xingang;Pan Jinbing;Zhang Xiaoju(Department of Respiratory and Critical Care Medicine,Henan Provincial People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院呼吸与危重症医学科,郑州450003

出　　处：《中国实用医刊》2021年第8期8-11,共4页Chinese Journal of Practical Medicine

基　　金：中国医药教育协会课题(2019LCYJ-001)。

摘　　要：目的分析急性呼吸衰竭(ARF)患者无创通气治疗失败的影响因素。方法抽取2019年1月至2020年1月于河南省人民医院行无创通气治疗的ARF患者113例,统计无创通气治疗失败和治疗成功情况,应用Logistic分析无创通气失败的影响因素。结果113例ARF患者行无创通气治疗失败12例(10.62%),治疗成功101例(89.38%)。Logistic回归分析显示,首次接受无创通气治疗(OR=9.100、P=0.001)、格拉斯哥昏迷量表(GCS)评分低(OR=1.346、P=0.011)、肺部感染程度重(OR=1.529、P=0.005)、二氧化碳分压(PaCO_(2))水平高(OR=2.323、P=0.001)、调节性T细胞(Treg)比例低(OR=35.925、P=0.001)是ARF患者无创通气治疗失败的影响因素。结论ARF患者的无创通气治疗有一定失败风险,可能与首次接受无创通气治疗、GCS评分低、肺部感染程度重、PaCO_(2)水平高、Treg细胞比例低等危险因素有关。Objective To analyze the influencing factors of failure of noninvasive ventilation(NIV)in the treatment of acute respiratory failure(ARF).Methods A total of 113 ARF patients who underwent NIV in Henan Provincial People’s Hospital from January 2019 to January 2020 were selected.The failure and success of NIV were counted,and the influencing factors of NIV failure were analyzed by Logistic.Results Of the 113 ARF patients,12 cases(10.62%)failed in NIV treatment,and 101 cases(89.38%)were successfully treated.Logistic regression analysis showed that for the first first time of treatment with NIV(OR=9.100,P=0.001),low glasgow coma scale(GCS)score(OR=1.346,P=0.011),severe pulmonary infection(OR=1.529,P=0.005),high partial pressure of carbon dioxide(PaCO2)level(OR=2.323,P=0.001),and the proportion of low regulatory T cells(Treg)(OR=35.925,P=0.001)were risk factors for failure of NIV in ART patients.Conclusions ARF patients have a certain risk of failure in the NIV treatment,which may be related to risk factors such as first time of treatment with NIV,low GCS score,severe pulmonary infection,high PaCO2 level,and low proportion of Treg cells.

关 键 词：呼吸衰竭 无创通气 肺部感染 

分 类 号：R563.8[医药卫生—呼吸系统]