高原地区ICU机械通气患者撤机失败的危险因素分析  

Risk Factors Analysis of Failed to Remove Machine in ICU Patients Undergoing Mechanical Ventilation in Plateau Areas

作　　者：普布次仁 强巴德吉 米玛 王小旭 李智勇 PUBU Ciren;QIANGBA Deji;MIma;WANG Xiaoxu;LI Zhiyong(Department of Intensive Care Medicine,Lhasa People's Hospital,Lhasa 850000,China;Department of Intensive Care Medicine,Beijing Geriatric Hospital Affiliated to Capital Medical University,Beijing 100069,China)

机构地区：[1]拉萨市人民医院重症医学科,西藏拉萨850000 [2]首都医科大学附属北京老年医院重症医学科,北京100069

出　　处：《反射疗法与康复医学》2024年第22期77-80,共4页Reflexology And Rehabilitation Medicine

基　　金：西藏自治区自然科学基金组团式援藏医学项目[XZ2023ZR-ZY28(Z)]。

摘　　要：目的分析高原地区重症监护室(ICU)机械通气患者撤机失败的危险因素。方法回顾性分析2023年8月—2024年4月拉萨市人民医院收治的100例ICU机械通气患者的临床资料,统计其撤机失败发生率,并收集患者的年龄、性别等信息,统计影响其撤机失败的高危因素。结果100例ICU机械通气患者中,共有23例(23.00%)发生撤机失败;Logistic回归分析显示,年龄>60岁(OR=5.000,95%CI=1.851~13.509)、体质指数(BMI)<18.5 kg/m^(2)(OR=10.988,95%CI=3.593~33.617)、有糖尿病(OR=9.880,95%CI=3.039~32.122)、有营养不良(OR=7.556,95%CI=2.625~21.748)、通气时间长(OR=8.031,95%CI=2.471~15.326)、急性生理学和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分高(OR=8.745,95%CI=2.832~18.798)、有多器官功能障碍综合征(MODS)(OR=5.612,95%CI=1.905~16.531)是ICU机械通气患者撤机失败发生的高危因素(P<0.05)。结论年龄>60岁、BMI<18.5 kg/m^(2)、有糖尿病、有营养不良、通气时间长、APACHEⅡ评分高、有MODS是高原地区ICU机械通气患者撤机失败发生的高危因素。Objective To analyze the risk factors of mechanical ventilation failure in intensive care unit(ICU)in plateau area.Methods Clinical data of 100 patients with mechanical ventilation in ICU admitted to Lhasa People's Hospital from August 2023 to April 2024 were retrospectively selected to analyze the incidence of failed to remove machine,and the age,gender and other information of patients were collected to analyze the highrisk factors affecting their failed to remove machine.Results Of 100 patients with mechanical ventilation in ICU,23(23.00%)failed to remove machine.Logistic regression analysis shows,age>60 years old(OR=5.000,95%CI=1.851~13.509),body mass index(BMI)<18.5 kg/m^(2)(OR=10.988,95%CI=3.593~33.617),diabetes mellitus(OR=9.880,95%CI=3.039~32.122),malnutrition(OR=7.556,95%CI=2.625~21.748),long ventilation time(OR=8.031,95%CI=2.471~15.326),high acute physiology and Chronic Health status score SystemⅡ(APACHEⅡ)score(OR=8.745,95%CI=2.832~18.798),multiple organ dysfunction syndrome(MODS)(OR=5.612,95%CI=1.905~16.531)was a high risk factor for failed to remove machine in ICU patients with mechanical ventilation(P<0.05).Conclusion Age>60 years old,BMI<18.5 kg/m^(2),diabetes,malnutrition,long ventilation time,high APACHEⅡscore,and MODS were high risk factors for failed to remove machine in ICU mechanical ventilation patients in plateau area.

关 键 词：机械通气 重症监护室 撤机失败 危险因素 

分 类 号：R459.7[医药卫生—急诊医学]