新型冠状病毒肺炎重症患者有创机械通气的影响因素分析  

Related factors of invasive ventilation in patients with severe COVID-19 in Shenzhen

作　　者：韩亚坤[1] 余德慧 黄煦晨 郑强虎 何仁亮[1] HAN Ya-kun;YU De-hui;HUANG Xu-chen;ZHENG Qiang-hu;HE Ren-liang(Department of Anesthesiology,Shenzhen Third People's Hospital,Shenzhen 518112,Guangdong,CHINA)

机构地区：[1]深圳市第三人民医院麻醉科,广东深圳518112

出　　处：《海南医学》2021年第17期2201-2204,共4页Hainan Medical Journal

摘　　要：目的探讨新型冠状病毒肺炎重症患者有创机械通气的相关影响因素。方法回顾性分析2020年1~11月深圳市第三人民医院收治的69例新型冠状病毒肺炎重症患者的临床资料。通过电子病历系统收集患者的基本信息,实验室检查基线值和诊疗方案,包括高血压病史、糖尿病病史、胸部CT、肌酐、谷丙转氨酶(ALT)、谷草转氨酶(AST)、凝血酶原时间(PT)、白蛋白、血红蛋白和T淋巴细胞的基线值,病程1周内中药清肺排毒汤、洛匹那韦/利托那韦、激素和胸腺法新使用情况,无创通气、输血史等。根据是否有创机械通气分为有创机械通气组22例和非有创通气组47例。采用单因素及多因素Logistic回归分析有创机械通气的独立危险因素。结果有创通气组与非有创通气组患者的年龄[(63.05±8.84)岁vs(56.55±11.85)岁]、基线白蛋白[(37.76±4.45)g/L vs(40.43±4.46)g/L]、病程1周内未使用清肺排毒汤(73%vs 23%)或洛匹那韦/利托那韦(77%vs 32%)、输血史(64%vs 13%)比较差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,病程1周内未使用清肺排毒汤或洛匹那韦/利托那韦及有输血史是重症患者有创机械通气的独立危险因素(P<0.05)。结论病程1周内未使用清肺排毒汤或洛匹那韦/利托那韦、有输血史为新型冠状病毒肺炎重症患者有创机械通气的独立高危因素。Objective To confirm the associated factors of invasive ventilation in patients with severe COVID-19.Methods A cross-sectional study was designed on patients with COVID-19 in the fever clinic of Shenzhen Third People’s Hospital from January to November in 2020.The basic information of the patients was collected through the electronic medical record system,and the baseline values and treatment plans were examined in the laboratory,including the history of hypertension,the history of diabetes,chest CT,baseline values of creatinine,alanine aminotransferase(ALT),aspartate aminotransferase(AST),prothrombin time(PT),albumin,hemoglobin,and T lymphocyte,as well as the usage of Qingfei detoxification decoction,ritonavir/ritonavir,hormone,and Thymalfasin within one week of the disease course,and the history of noninvasive ventilation and blood transfusion.According to whether there was invasive mechanical ventilation,the patients were divided into invasive mechanical ventilation group(22 cases)and non-invasive mechanical ventilation group(47 cases).Univariate and multivariate logistic regression were used to analyze the independent risk factors of invasive mechanical ventilation.Results The invasive mechanical ventilation group and the non-invasive ventilation group showed statistically significant difference in the following indexes(P<0.05):age,(63.05±8.84)years vs(56.55±11.85)years;albumin at baseline,(37.76±4.45)g/L vs(40.43±4.46)g/L;the percentage of not using Qingfei detoxification decoction(73%vs 23%)or ritonavir/ritonavir within one week of the disease course(77%vs32%);history of blood transfusion(64%vs 13%).Multivariate logistic regression analysis showed that not using Qingfei detoxification decoction or lopinavir/ritonavir within 1 week and the history of blood transfusion were the independent risk factors of invasive ventilation in patients with severe COVID-19(P<0.05).Conclusion Not using Qingfei detoxification decoction or lopinavir/ritonavir within 1 week and the history of blood transfusion were indepe

关 键 词：新型冠状病毒肺炎 有创机械通气 中医药 洛匹那韦/利托那韦 输血史 

分 类 号：R511[医药卫生—内科学]