老年ECMO患者早期急性胃肠损伤发生的影响因素分析  

Analysis of Influencing Factors of Early Acute Gastrointestinal Injury in Elderly Patients with ECMO

作　　者：姜文学 韦巧 王驰 吕立文[2] JIANG Wen-xue;WEI Qiao;WANG Chi;LYU Li-wen(Graduate School of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China;Emergency Department of Guangxi Zhuang Autonomous Region People's Hospital,Nanning 530000,Guangxi,China)

机构地区：[1]右江民族医学院研究生学院,广西百色533000 [2]广西壮族自治区人民医院急诊科,广西南宁530000

出　　处：《医学信息》2023年第12期91-95,共5页Journal of Medical Information

基　　金：广西医疗卫生适宜技术开发与推广应用项目(编号:S2021049)。

摘　　要：目的探讨老年体外膜肺氧合(ECMO)患者上机早期急性胃肠损伤(AGI)发生的影响因素。方法回顾分析2020年12月-2021年12月广西壮族自治区人民医院急诊监护病房收治的老年ECMO患者23例,评估其早期急性胃肠损伤的发生情况,按照2012年欧洲重症医学会关于重症患者急性胃肠损伤分级指导意见,将患者分为AGI组与非AGI组,比较两组早期急性胃肠损伤发生率、ECMO上机时血气分析结果、ECMO转机后ECMO参数、血流动力学指标及生化指标,探讨老年ECMO患者早期发生AGI的影响因素。结果23例发生AGI 16例,未发生7例,AGI发生率为69.57%;AGI组与非AGI组BMI、性别、血管活性药物指数(VIS)及ECMO上机乳酸水平比较,差异有统计学意义(P<0.05);Logistic二元回归分析显示:BMI是老年ECMO患者早期发生AGI的独立危险因素。结论BMI、性别、VIS、上机时乳酸是老年ECMO患者早期发生AGI的影响因素,其中BMI是老年ECMO患者早期发生AGI的独立危险因素。Objective To investigate the influencing factors of acute gastrointestinal injury(AGI)in elderly patients undergoing extracorporeal membrane oxygenation(ECMO).Methods A retrospective analysis of 23 elderly patients with ECMO admitted to the emergency intensive care unit of the People's Hospital of Guangxi Zhuang Autonomous Region from December 2020 to December 2021 was conducted to evaluate the occurrence of early acute gastrointestinal injury.According to the 2012 European Society of Intensive Care Medicine's guidance on the classification of acute gastrointestinal injury in critically ill patients,the patients were divided into AGI group and non-AGI group.The incidence of early acute gastrointestinal injury,blood gas analysis results during ECMO,ECMO parameters,hemodynamic indexes and biochemical indexes after ECMO transfer were compared between the two groups to explore the influencing factors of early AGI in elderly ECMO patients.Results Among the 23 patients,16 patients had AGI and 7 patients had no AGI,the incidence of AGI was 69.57%.There were significant differences in BMI,gender,vasoactive drug index(VIS)and lactic acid level on ECMO between AGI group and non-AGI group(P<0.05).Logistic binary regression analysis showed that BMI was an independent risk factor for early AGI in elderly patients with ECMO.Conclusion BMI,gender,VIS,and lactic acid on the machine are the influencing factors of early AGI in elderly ECMO patients,and BMI is an independent risk factor for early AGI in elderly ECMO patients.

关 键 词：体外膜肺氧合 急性胃肠损伤 血流动力学 乳酸 

分 类 号：R459.7[医药卫生—急诊医学]