慢性阻塞性肺疾病急性加重期呼吸衰竭有创机械通气撤机时机影响因素分析  

Analysis of Factors Influencing the Timing of Invasive Mechanical Ventilation Withdrawal in Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Respiratory Failure

作　　者：游昌强 YOU Chang-qiang(Fujian Jian’ou Municipal Hospital,Fujian Nanping 353100)

机构地区：[1]福建省建瓯市立医院,福建南平353100

出　　处：《中国医疗器械信息》2023年第19期131-133,共3页China Medical Device Information

摘　　要：目的:分析慢性阻塞性肺疾病(简称慢阻肺)急性加重期呼吸衰竭有创机械通气撤机时机的影响因素。方法:回顾分析本院2020年12月~2022年12月收治的80例慢阻肺急性加重期呼吸衰竭患者,所有患者入院后均接受有创机械通气治疗,其中,通气治疗后出现撤机困难患者19例(观察组),顺利撤机患者61例(对照组)。收集两组患者的临床资料,分析影响撤机的风险因素。结果:单因素分析可见:两组患者身体质量指数、通气时间、急性生理与慢性健康(APACHEⅡ)评分、插管前血红蛋白,插管后的白细胞计数、血红蛋白及C反应蛋白,以及呼吸机相关性肺炎和血清白蛋白,以上指标对比有统计学意义(P<0.05)。多因素分析可见:患者身体质量指数、通气时间、APACHEⅡ评分、插管前血红蛋白,以及插管后的白细胞计数、C反应蛋白和血红蛋白,是延迟慢阻肺急性加重期呼吸衰竭有创机械通气撤机的危险因素(P<0.05);而呼吸机相关性肺炎和血清白蛋白则为保护因素(P>0.05)。结论:针对慢阻肺急性加重期呼吸衰竭有创机械通气治疗患者,临床应加大治疗临床指征监督工作,明确危险因素,提高顺利撤机率。Objective:Analyze the influencing factors of the timing of invasive mechanical ventilation withdrawal in acute exacerbation of chronic obstructive pulmonary disease with respiratory failure.Methods:A retrospective analysis of 80 patients with acute exacerbation of chronic obstructive pulmonary disease with respiratory failure admitted to our hospital from December 2020 to December 2022.All patients received invasive mechanical ventilation treatment after admission,among them,19 patients(study group)experienced difficulty in withdrawal after ventilation treatment,and 61 patients(control group)successfully withdrawal.Clinical data were collected from both groups and risk factors affecting the withdrawal were analyzed.Results:Single factor analysis shows that:The comparison of body mass index,ventilation time,APACHE II,pre intubation hemoglobin,post intubation white blood cell count,hemoglobin and C-reactive protein,as well as ventilator-associated pneumonia and serum albumin between the two groups of patients showed statistical significance(P<0.05).Multiple factor analysis shows that:Patient body mass index,ventilation time,APACHE II score,pre intubation hemoglobin,as well as post intubation white blood cell count,C-reactive protein,and hemoglobin,are risk factors for delayed invasive mechanical ventilation withdrawal in acute exacerbation of chronic obstructive pulmonary disease(COPD)with respiratory failure(P<0.05);Ventilator associated pneumonia and serum albumin were protective factors(P>0.05).Conclusion:For patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure treated with invasive mechanical ventilation,clinical supervision of treatment indications should be strengthened,risk factors should be identified,and the probability of successful withdrawal should be increased.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 有创机械通气 因素分析 

分 类 号：TH778[机械工程—仪器科学与技术]