Ⅱ型呼吸衰竭患者使用无创机械通气治疗并发腹胀的高危因素  

High-risk factors for patients with type Ⅱ respiratory failure using non-invasive mechanical ventilation to treat abdominal distension

作　　者：黄金莹 彭博[1] 徐蕤[1] 许军 HUANG Jin-ying;PENG Bo;XU Rui;XU Jun(Department of Critical Care Medicine,Beijing Fengtai Hospital,Beijing100070,China)

机构地区：[1]北京丰台医院重症医学科,北京100070

出　　处：《中国当代医药》2021年第28期68-71,共4页China Modern Medicine

摘　　要：目的探讨Ⅱ型呼吸衰竭患者使用无创机械通气治疗并发腹胀的高危因素。方法回顾性分析2019年1月至2020年11月在北京丰台医院行无创机械通气的118例Ⅱ型呼吸衰竭患者临床资料,分析Ⅱ型呼吸衰竭患者无创机械通气治疗后并发腹胀的高危因素。结果无创机械通气治疗后,并发腹胀的Ⅱ型呼吸衰竭患者有52例(44.07%),未并发腹胀66例(55.93%)。单因素分析显示,年龄、自主进食、胃肠减压、张口呼吸、24 h通气总时间、电解质变化、胃肠功能改变与Ⅱ型呼吸衰竭患者无创机械通气治疗后并发腹胀有关,差异有统计学意义(P<0.05);性别、鼻饲、呼出正压支持、吸入正压支持、肺部感染与Ⅱ型呼吸衰竭患者无创机械通气治疗后并发腹胀无关,差异无统计学意义(P>0.05);多因素分析显示,年龄≥60岁(β=1.059,OR=2.884,95%CI=1.322~6.292)、张口呼吸(β=2.216,OR=9.173,95%CI=3.939~21.364)、24 h通气总时间≥10 h(β=1.866,OR=6.462,95%CI=2.767~15.090)、电解质变化(β=2.659,OR=14.280,95%CI=5.815~35.065)、胃肠功能改变(β=1.427,OR=4.167,95%CI=1.819~9.546)是Ⅱ型呼吸衰竭患者无创机械通气治疗后并发腹胀的相关因素(P<0.05)。结论Ⅱ型呼吸衰竭患者无创机械通气治疗后并发腹胀与年龄、张口呼吸、24 h通气总时间、电解质变化、胃肠功能改变密切相关,临床需加以重视。Objective To investigate the high-risk factors of abdominal distension in patients with typeⅡrespiratory failure using non-invasive mechanical ventilation.Methods The clinical data of 118 patients with typeⅡrespiratory failure who underwent non-invasive mechanical ventilation in Beijing Fengtai Hospital from January 2019 to November 2020 were retrospectively analyzed,and the high-risk factors of abdominal distension in patients with typeⅡrespiratory failure after non-invasive mechanical ventilation were analyzed.Results After non-invasive mechanical ventilation treatment,52 cases(44.07%)of typeⅡrespiratory failure patients with abdominal distension,66 cases(55.93%)without abdominal distension;univariate analysis showed that age,self-feeding,gastrointestinal decompression,open-mouth breathing,24 h total ventilation time,electrolyte changes and gastrointestinal function changes were associated with abdominal distension after non-invasive mechanical ventilation in patients with typeⅡrespiratory failure,and the difference was statistically significant(P<0.05).Gender,nasal feeding,exhalation positive pressure support,inhalation positive pressure support,lung infection had no significant difference with abdominal distension after non-invasive mechanical ventilation(P>0.05).Multivariate analysis showed that age≥60 years(β=1.059,OR=2.884,95%CI=1.322-6.292),open-mouth respiration(β=2.216,OR=9.173,95%CI=3.939-21.364),24 h total ventilation time≥10 h(β=1.866,OR=6.462,95%CI=2.767-15.090),electrolyte changes(β=2.659,OR=14.280,95%CI=5.815-35.065),gastrointestinal function changes(β=1.427,OR=4.167,95%CI=1.819-9.546)were associated with abdominal distension after non-invasive mechanical ventilation in patients with typeⅡrespiratory failure(P<0.05).Conclusion Abdominal distension in patients with typeⅡrespiratory failure after non-invasive mechanical ventilation is closely related to age,mouth-opening breathing,total time of 24 h ventilation,changes in electrolytes,and changes in gastrointestinal function,a

关 键 词：Ⅱ型呼吸衰竭 无创机械通气 腹胀 危险因素 张口呼吸 

分 类 号：R563.8[医药卫生—呼吸系统]