慢性阻塞性肺疾病呼吸衰竭合并肺部感染的危险因素分析  

Analysis of risk factors of chronic obstructive pulmonary disease respiratory failure complicated with pulmonary infection

作　　者：袁茹 袁晓洁 陆颍 YUAN Ru;YUAN Xiao-jie;LU Ying(Department of Geriatric Respiratory Sleep,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;General Hospital of the Chinese People's Liberation Army,Beijing 100853,China)

机构地区：[1]郑州大学第一附属医院老年呼吸睡眠科,郑州450052 [2]中国人民解放军总医院,北京100853

出　　处：《医药论坛杂志》2024年第5期449-452,共4页Journal of Medical Forum

基　　金：河南省重点研发与推广专项(202102310117)。

摘　　要：目的分析慢性阻塞性肺疾病(COPD)呼吸衰竭合并肺部感染病人的危险因素。方法采用简便抽样法选取2021年1月—2022年1月治疗的郑州大学第一附属医院COPD呼吸衰竭患者87例作为研究对象,根据是否合并肺部感染分为感染组和未感染组。收集患者性别、年龄、基础疾病等资料,探讨诱发COPD呼吸衰竭合并肺部感染的相关危险因素及感染病原菌分布特点,并根据危险因素制定相应预防对策。结果87例COPD呼吸衰竭患者中合并肺部感染者51例(58.62%),未合并肺部感染者36例(41.38%)。logistic回归分析显示,年龄≥65、使用机械通气、患有低蛋白血症、存在糖尿病史、长时间住ICU、长期使用抗生素、长期使用糖皮质激素是COPD呼吸衰竭患者合并肺部感染的独立危险因素(P<0.05)。51例合并肺部感染患者共检出病原菌81株,其中真菌17株(20.99%),革兰阴性菌株36株(44.44%),革兰阳性菌株28株(34.57%)。结论COPD呼吸衰竭患者合并肺部感染与年龄、机械通气、低蛋白血症、糖尿病史、ICU住院时间以及抗生素和糖皮质激素的使用等多种因素有关,应针对以上危险因素采取有效监测和干预,做好病原菌隔离防护,以进一步降低COPD呼吸衰竭患者并发肺部感染发生风险,提高患者预后。Objective To explore the risk factors of chronic obstructive pulmonary disease(COPD)respiratory failure compli⁃cated with pulmonary infection,and to explore the effect of comprehensive intervention mode on pulmonary function of pa⁃tients.Methods By simple sampling method,87 patients with COPD respiratory failure who were treated in our hospital from Jan.2021 to Jan.2022 were selected as the research objects,and divided into infection group and non-infection group ac⁃cording to whether they were complicated with pulmonary infection.The gender,age and underlying diseases of the patients were collected to explore the risk factors of COPD respiratory failure complicated with pulmonary infection and the distribution characteristics of infectious pathogens,and corresponding preventive measures were formulated according to the risk factors.Results Toatlly 51 patients(58.62%)with pulmonary infection and 36 patients(41.38%)without pulmonary infection in 87 COPD patients with respiratory failure.Logistic regression analysis showed that age≥65,use of mechanical ventilation,hypoproteinemia,history of diabetes,long-term ICU stay,long-term use of antibiotics,long-term use of glucocorticoids were independent risk factors for pulmonary infection in COPD patients with respiratory failure(P<0.05).A total of 81 pathogens were detected in patients with pulmonary infection,including 17 fungi,36 gram-negative strains and 28 gram-positive strains.Conclusion COPD patients with respiratory failure by pulmonary infection is related to age,mechanical ven⁃tilation,hypoalbuminemia,history of diabetes mellitus,length of ICU stay and antibiotics and the use of glucocorticoid.The risk factors should be effectively monitoring and intervention,to further reduce the risk of pulmonary infection in COPD patients with respiratory failure and improve the prognosis of patients through pathogen isolation and protection.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 肺部感染 危险因素 综合干预模式 肺功能 

分 类 号：R563[医药卫生—呼吸系统]